Skip to main content
×
×
Home

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

  • Amanda S. Newton (a1) (a2), Samina Ali (a1), David W. Johnson (a3), Christina Haines (a1) (a2), Rhonda J. Rosychuk (a1) (a2), Rachel A. Keaschuk (a4), Philip Jacobs (a5) and Terry P. Klassen (a1)...
Abstract
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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      A 4-year review of pediatric mental health emergencies in Alberta
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      A 4-year review of pediatric mental health emergencies in Alberta
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      A 4-year review of pediatric mental health emergencies in Alberta
      Available formats
      ×
Copyright
Corresponding author
Department of Pediatrics, St. Paul's Hospital, Faculty of Medicine and Dentistry, #8213 Aberhart Centre One, 11402 University Ave., Edmonton AB T6G 2J3; mandi.newton@ualberta.ca
References
Hide All
1.Christodulu, KV, Lichenstein, R, Weist, M, et al Psychiatric emergencies in children. PediatrEmerg Care 2002;18:268–70.
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.
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.
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.
5.Reder, S, Quan, L. Emergency mental health care for youth in Washington State. Pediatr Emerg Care 2004;20:742–8.
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.
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.
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.
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.
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.
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.
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.
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.
14.Sills, MR, Bland, SD. Summary statistics for pediatric psychiatric visits to US Emergency Departments, 1993–1999. Pediatrics 2002;110:15.
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).
16.2005 ACCS manual. Edmonton (AB): Alberta Health and Wellness; 2005.
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.
18.Beveridge, R, Clarke, B, Janes, L, et al Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. CJEM. 1999; 1(3 Suppl).
19.1996 census dictionary. Ottawa (ON): Statistics Canada. 1999.
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).
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.
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.
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;24:399408.
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.
25.Canadian Institutes of Health Information. Canadian classification of health interventions (vol. 4). Ottawa (ON): The Institutes; 2006.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Canadian Journal of Emergency Medicine
  • ISSN: -
  • EISSN: 1481-8035
  • URL: /core/journals/canadian-journal-of-emergency-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed