Emergency Mental Health Services for Children and Youth: A Multi-site Study of Clinical Indicators for Patient Needs, Decision-making, and Service Delivery

Awareness and discussion about the impact of mental health and illness across the country has been increasing. Roughly, 15% of children and youth live with a mental illness but only 1 in 6 receive mental health services. The hospital emergency department (ED) is often the first place the most distressed and at risk children and youth go for service. On any given hour in almost all major centres, there is a child or youth being assessed for suicide risk, severe behaviour problems, or a major emotional event. However, the range of mental health emergency services provided and the follow-up care after discharge vary with little understanding of what is influencing decision-making. For the children and youth who come to the ED with these concerns, there are presently no consistent guidelines, that have been researched in Canada, to determine whether a child or youth should be seen by an emergency room physician, psychiatrist, or crisis worker and whether admission to hospital or return to the community is the best course of action. The result, unfortunately, can be tragic when this system fails. We propose to conduct a multi site study that describes the needs of children and youth who are presenting to four children's emergency health centres, and describe the type of emergency and follow-up mental health services recommended and obtained. Upon presentation to the ED, eligible patients and accompanying primary caregivers will be approached for participation in the study. Those who chose to participate will complete a few questionnaires and their clinician will complete an assessment designed to identify needs for service. They will be contacted by phone one month post Ed visit for feedback regarding satisfaction with the ED visit and experiences with following-up with ED recommendations. The results of our research will be used to improve the services we provide for children and youth experiencing a mental health crisis.