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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; mandi.newton@ualberta.ca

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

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