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A 4-year review of pediatric mental health emergencies in Alberta

Published online by Cambridge University Press:  21 May 2015

Amanda S. Newton ,
Samina Ali ,
David W. Johnson ,
Christina Haines ,
Rhonda J. Rosychuk ,
Rachel A. Keaschuk ,
Philip Jacobs  and
Terry P. Klassen
Amanda S. Newton*
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. Women and Children's Health Research Institute, Edmonton, Alta.
Samina Ali
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.
David W. Johnson
Affiliation:
Departments of Pediatrics and Pharmacology & Therapeutics, Faculty of Medicine, University of Calgary, Calgary, Alta.
Christina Haines
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. Women and Children's Health Research Institute, Edmonton, Alta.
Rhonda J. Rosychuk
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. Women and Children's Health Research Institute, Edmonton, Alta.
Rachel A. Keaschuk
Affiliation:
Pediatric Centre for Weight and Health, Stollery Children's Hospital, Edmonton, Alta.
Philip Jacobs
Affiliation:
Institute of Health Economics, Edmonton, Alta.
Terry P. Klassen
Affiliation:
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.
*
Department of Pediatrics, St. Paul's Hospital, Faculty of Medicine and Dentistry, #8213 Aberhart Centre One, 11402 University Ave., Edmonton AB T6G 2J3; [email protected]

Abstract

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Objective:

We sought to determine and compare rates of pediatric mental health presentations and associated costs in emergency departments (EDs) in Alberta.

Methods:

We examined 16 154 presentations by 12 589 patients (patient age ≤ 17 yr) between April 2002 and March 2006 using the Ambulatory Care Classification System, a province-wide database for Alberta. The following variables of interest were extracted: patient demographics, discharge diagnoses, triage level, disposition, recorded costs for ED care, and institutional classification and location (i.e., rural v. urban, pediatric v. general EDs).

Results:

A 15% increase in pediatric mental health presentations was observed during the study period. Youth aged 13-17 years consistently represented the most common age group for first presentation to the ED (83.3%). Of the 16 154 recorded presentations, 21.4% were related to mood disorders and 32.5% to anxiety disorders. Presentations for substance misuse or abuse were the most prevalent reasons for a mental health-related visit (41.3%). Multiple visits accounted for more than one-third of all presentations. Presentations for mood disorders were more common in patients with multiple compared with single visits (29.3% v. 16.9%), and substance abuse or misuse presentations were more common in patients with single compared with multiple visits (47.4% v. 30.5%). The total direct ED costs for mental health presentations during the study period was Can$3.5 million.

Conclusion:

This study provides comprehensive data on trends of pediatric mental health presentation, and highlights the costs and return presentations in this population. Psychiatric and medical care provided in the ED for pediatric mental health emergencies should be evaluated to determine quality of care and its relationship with return visits and costs.

Keywords

pediatricsmental healthcrisis visitsemergency
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 5 , September 2009 , pp. 447 - 454
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

REFERENCES

1.Christodulu, KV, Lichenstein, R, Weist, M, et al Psychiatric emergencies in children. PediatrEmerg Care 2002;18:268–70.Google Scholar
2.Guinto-Ocampo, H, Molczan, K, Selbst, S. The epidemiology of mental health emergencies presenting to pediatric emergency departments [abstract]. Pediatric Academic Societies 2006;59:112.Google Scholar
3.Goldstein, AB, Horwitz, SM. Child and adolescent psychiatric emergencies in nonsuicide-specific samples: the state of the research literature. Pediatr Emerg Care 2006;22:379–84.Google Scholar
4.American Academy of Pediatrics; American College of Emergency Physicians, Dolan MA, Mace SE. Pediatric mental health emergencies in the emergency medical services system. Ann Emerg Med 2006;48:484–6.Google Scholar
5.Reder, S, Quan, L. Emergency mental health care for youth in Washington State. Pediatr Emerg Care 2004;20:742–8.Google Scholar
6.Santiago, LI, Tunik, MG, Foltin, GL, et al Children requiring psychiatric consultation in the pediatric emergency department. Pediatr Emerg Care 2006;22:85–9.Google Scholar
7.American Academy of Pediatrics, Committee on Pediatric Emergency Medicine. Pediatric mental health emergencies in the emergency medical services system. Pediatrics 2006;118:1764–7.Google Scholar
8.Parker, KC, Roberts, N, Williams, C, et al Urgent adolescent psychiatric consultation: from the accident and emergency department to inpatient adolescent psychiatry. J Adolesc 2003;26:283–93.Google Scholar
9.Smith, DH, Hadorn, DC. Lining up for children’s mental health services: a tool for prioritizing waiting lists. J Am Acad Child Adolesc Psychiatry 2002;41:367–77.Google Scholar
10.Kirby, MJL, Keon, WJ. Out of the shadows at last: transforming mental health, mental illness and addiction services in Canada. Ottawa (ON): Standing Senate Committee on Social Affairs, Science & Technology; 2006.Google Scholar
11.Offord, DR, Boyle, MH, Szatmari, P, et al Ontario child health study II: six-month prevalence of disorder and rates of service utilization. Arch Gen Psychiatry 1987;44:832–6.Google Scholar
12.Offord, DR, Boyle, MH, Fleming, JE, et al Ontario child health study: summary of the selected results. Can J Psychiatry 1989;34:483–91.Google Scholar
13.Shah, MV, Amato, CS, John, AR, et al Emergency department trends for pediatric and pediatric psychiatric visits. Pediatr Emerg Care 2006;22:685–6.Google Scholar
14.Sills, MR, Bland, SD. Summary statistics for pediatric psychiatric visits to US Emergency Departments, 1993–1999. Pediatrics 2002;110:1–5.Google Scholar
15.World Health Organization. International statistical classification of diseases and related health problems, tenth edition). Available: www.who.int/classifications/icd/en/ (accessed 2009 Aug 6).Google Scholar
16.2005 ACCS manual. Edmonton (AB): Alberta Health and Wellness; 2005.Google Scholar
17.Murray, M, Bullard, M. Grafstein, E.; CTAS and CEDrosoph Inf Serv National Working Groups. Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines. CJEM 2004;6:421–7.Google Scholar
18.Beveridge, R, Clarke, B, Janes, L, et al Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. CJEM. 1999; 1(3 Suppl).Google Scholar
19.1996 census dictionary. Ottawa (ON): Statistics Canada. 1999.Google Scholar
20.Terminology. Ottawa (ON): Indian and Northern Affairs Canada; 2003. Available: www.ainc-inac.gc.ca/ai/mr/is/tln-eng.asp (accessed 2009 Aug 6).Google Scholar
21.Kunz, FM, French, MT, Bazargan-Hejazi, S. Cost-effectiveness analysis of a brief intervention delivered to problem drinkers presenting at an inner-city hospital emergency department. J Stud Alcohol 2004;65:363–70.Google Scholar
22.Mancuso, D, Nordlund, DJ, Felver, BEM. Chemical dependency treatment reduces emergency room costs and visits. Olympia (WA): Washington State DSHS, Research and Data Analysis Division; 2004.Google Scholar
23.Baren, JM, Mace, SE, Hendry, PL, et al Children’s mental health emergencies — Part 1. Challenges in care: definition of the problem, barriers to care, screening, advocacy, and resources. Pediatr Emerg Care 2008;24:399–408.Google Scholar
24.Goldstein, AB, Frosch, E, Davarya, S, et al Factors associated with a six-month return to emergency services among child and adolescent psychiatric patients. Psychiatr Serv 2007;58:1489–92.Google Scholar
25.Canadian Institutes of Health Information. Canadian classification of health interventions (vol. 4). Ottawa (ON): The Institutes; 2006.Google Scholar