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Cyclic variations in demand for out-of-hours services in child and adolescent psychiatry: implications for service planning

  • Thomas Hillen (a1) and Eduardo Szaniecki (a2)
Abstract
Aims and method

We examined peaks and troughs in demand for out-of-hours consultations and assessments in child and adolescent psychiatry and whether these have implications for service development. All out-of-hours referrals in three teaching hospitals providing services to a large and diverse inner-city population were prospectively registered from 1 January 2002 to 31 December 2005.

Results

In total, 323 individuals under 18 years were referred; 21.6 (95% CI 19.3-24.0) per 100 000 general population per year. Bedside assessments were required in 37%, the remainder were dealt with by telephone. The work took more than 4 h for 22%; 46% of individuals presenting were aged 16-18 years. Significant diurnal variation was observed with a peak in referrals between 17.00 h and 00.59 h. More referrals were made when daytime liaison services were closed (odds ratio (OR) = 2.46, 95% CI 1.15-1.87), after referral pathways had been clarified (OR = 2.33, 95% CI 1.92-3.23) and during spring (OR = 1.50, 95% CI 1.14-1.98). Other factors analysed showed no association with referral activity.

Clinical implications

Cyclic variations in the demand for out-of-hours services in child and adolescent psychiatry should be considered for service planning. Although paediatric psychiatric emergencies are relatively rare, they can take up considerable clinician time.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Thomas Hillen (thillen2@tavi-port.nhs.uk)
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Declaration of interest

None.

Footnotes
References
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1 Edelsohen, G, Braitman, LE, Rabinovisch, H, Sheves, P, Melendez, A. Predictors of urgency in a pediatric psychiatric emergency service. JAm Acad Child Adolesc Psychiatry 2003; 42: 1197–202.
2 Soskis, CW. Emergency room on weekends: the only game in town. Health Social Work 1980; 5: 3743.
3 Grupp-Phelan, J, Harmon, J, Kelleher, KJ. Trends in mental health and chronic condition visits by children presenting for care at US emergency departments. Public Health Rep 2007; 122: 5561.
4 Mental Health Foundation. Truth Hurts. Report of the National Inquiry into Self-harm among Young People. Mental Health Foundation, 2006.
5 Street, C. Whose Crisis? Meeting The Needs of Children and Young People with Serious Mental Health Problems. Young Minds, 2000.
6 National Institute for Health and Clinical Excellence. Self-Harm: The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care. The British Psychological Society and The Royal College of Psychiatrists, 2004.
7 Royal College of Psychiatrists. Managing Deliberate Self-Harm in Young People. Council Report CR64. Royal College of Psychiatrists, 1998.
8 HM Government. Every Child Matters: Change for Children. Department for Education and Skills, 2004.
9 Storey, P, Statham, J. Emergency support: whose crisis now? Community Care 2007; 11 October (http://www.communitycare.co.uk/Articles/2007/10/11/106086/mental-health-crisis-among-young-people-research.htm).
10 Bennewith, O, Gunnell, D, Peteres, TJ, Hawton, K, House, A. Variation in the hospital management of self-harm in adults in England: observational study. BMJ 2004; 328: 1108–9.
11 Hawton, K, Bergen, H, Cassey, D, Simkin, S, Plamer, B, Cooper, J, et al. Self-harm in England: a tale of three cities. Soc Psychiatry Psychiatr Epidemiol 2007; 42: 513–21.
12 Rushton, J, Bruckman, D, Kelleher, K. Primary care referral of children with psychosocial problems. Arch Pediatr Adolesc Med 2002; 156: 592–8.
13 Bergen, H, Hawton, K. Variation in deliberate self-harm around Christmas and New Year. Soc Sci Med 2007; 65: 855–67.
14 Bergen, H, Hawton, K. Variations in time of hospital presentation for deliberate self-harm and their implications for clinical services. J Affect Disord 2007; 98: 227–37.
15 Blenkiron, P. The timing of deliberate self harm behaviour. Ir J Psychol Med 2003; 20: 126–31.
16 Jessen, G, Steffensen, P, Jensen, BF. Seasons and meteorological factors in suicidal behaviour. Arch Suicide Res 1998; 4: 263–80.
17 Office for National Statistics. Census 2001: the most comprehensive survey of the UK population. ONS, 2001 (http:/www.statistics.gov.uk/census2001/census2001.asp).
18 Hakko, H, Rasanen, P, Tiihonen, J, Nieminen, P. Use of statistical techniques in studies of suicide seasonality, 1970 to 1997. Suicide Life Threat Behav 2002; 32: 191208.
19 Worrall, A, O'Herlihy, A, Banerjee, S, Jaffa, T, Lelliott, P, Hill, P, et al. Inappropriate admission of young people with mental disorder to adult psychiatric wards and paediatric wards: cross sectional study of six months' activity. BMJ 2004; 328: 867-8.
20 Parker, KCH, Roberts, N, Williams, C, Benjamin, M, Cripps, L, Woogh, C. Urgent adolescent psychiatric consultation: from accident and emergency department to inpatient adolescent psychiatry. J Adolesc 2003; 26: 283-93.
21 Eastwood, MR, Stiasny, S. Psychiatric disorder, hospital admission, and season. Arch Gen Psychiatry 1978; 35: 769-71.
22 Hawton, K, Hall, S, Simkin, S, Bale, L, Bond, A, Codd, S, et al. Deliberate selfharm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. J Child Psychol Psychiatry 2003; 44: 1191-8.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Cyclic variations in demand for out-of-hours services in child and adolescent psychiatry: implications for service planning

  • Thomas Hillen (a1) and Eduardo Szaniecki (a2)
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