Emergency mental health care for chi̇ldren and adolescents outside of regular working hours: 7 years outcomes from a tertiary hospital

• Published in: Asian journal of psychiatry 2022-06, Vol.72, p.103103-103103, Article 103103
• Main Authors: Poyraz Fındık, Onur Tuğçe, Fadıloğlu, Eray, Ay, Pınar, Fiş, Neşe Perdahlı
• Format: Article
• Language: English
• Subjects: Adolescents; Depression; Emergency; Mental health; Psychiatry
• ISSN: 1876-2018; 1876-2026
• DOI: 10.1016/j.ajp.2022.103103

This study aims to define the clinical characteristics and management strategies of children and adolescents presenting with psychiatric crises to the emergency department (ED) of a tertiary health care facility outside of working hours, and to identify predictors of multiple ED visits among them. From January 2012 to December 2018, retrospective records of patients presenting with psychiatric symptoms to the ED and examined by a child psychiatrist after 5 p.m. on weekdays and for 24 h on weekends and public holidays were analyzed. Our sample consisted of 1576 visits and 1364 patient (Female:Male=1.8:1, mean age=14.86 ± 2.72). The most common reason for visits was self-injurious thought or behaviors (SITB), and the most common diagnosis was depression. While depression was statistically more common in girls, attention deficit hyperactivity disorder, autism and/or intellectual disability (ASD/ID), psychotic disorders, and bipolar disorder were more common in boys. The forensic evaluation was the most common reason for visits among children younger than 6 years old. Of visits, 23% transferred to hospitalization. A history of mental health contact was the lowest in depression (37.5%), psychosis (34.1%), and substance use disorders (33%). Of patients, 10.8% had multiple visits. A history of mental health contacts, conduct disorder, ASD/ID, bipolar disorder, psychotic disorder, and dissociative disorder were predictors of multiple visits to ED with psychiatric reasons. Emergency mental health care outside of regular working hours can be a critical step in the diagnosis and treatment of serious psychiatric disorders in children and adolescents. •Forensic issues are the most important reason for urgent psychiatric assessment in young children.•Self-harm is the most common reason for seeking emergency psychiatric care in adolescents.•Girls present to the ED with a psychiatric crisis about twice as often as boys•Depression is the most common diagnosis in emergency psychiatric admissions.•Multiple ED visits may results from difficulties in symptom management.