Child and Adolescent Mental Health Problems and Substance Use Presentations to an Emergency Department

2011 ◽  
Vol 19 (6) ◽  
pp. 521-525 ◽  
Author(s):  
Lisa Bell ◽  
Robyn Stargatt ◽  
Peter Bosanac ◽  
David Castle ◽  
George Braitberg ◽  
...  

Objective: The aim of this study was to determine the characteristics and referral pattern of children and adolescents with mental health problems, substance misuse and comorbidity presenting to the emergency department (ED) of a large public hospital. Method: A file audit of the ED information system was conducted over a 12 month period. Outcome measures included age, gender, diagnostic presentation, assessment, referral and disposal. Results: Forty-four substance misuse, 128 mental health and 82 comorbidity presentations were identified; 80% required treatment within 30 minutes. Few substance misuse cases were seen by mental health services and no substance misuse cases were referred for mental health service assessment. All mental health and comorbidity cases were seen by mental health services; 41% were referred to outpatient and 18% to inpatient services. Those with mental health problems displayed high levels of self-mutilation, and those with comorbidity displayed high levels of self-mutilation and substance misuse. Alcohol use was common in the substance misuse group, and over the counter or prescription medications were abused by the mental health and comorbidity groups. Conclusions: This age group places a high demand on the ED. All children and adolescents with recognized mental health symptoms were seen by mental health services, but those with substance misuse were not. Given the long-term problems associated with substance misuse, this is a missed opportunity for intervention.

2020 ◽  
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjærsdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen

Abstract Background: Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method: In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results: The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion: Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.


2021 ◽  
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjaersdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen

Abstract Background Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking.Conclusion Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.


2020 ◽  
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjaersdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen

Abstract Background: Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method: In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results: The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion: Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.


Author(s):  
Anna Sofie Hansen ◽  
Gry Kjaersdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen

Abstract Background Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.


2005 ◽  
Vol 39 (1-2) ◽  
pp. 74-80 ◽  
Author(s):  
Ross Kalucy ◽  
Lyndall Thomas ◽  
Diane King

Objective: Deinstitutionalization and mainstreaming may have contributed to increased attendance in public emergency departments by people with mental health problems. This study describes changing patterns of attendances by patients with mental health problems to the emergency department (ED) of a public teaching hospital in Adelaide, South Australia. Method: Records from a 10-year period from the ED were examined to identify changes in the number of, and diagnoses for, patients attending for primarily mental health concerns. Admission rates, detention and length of stay (LOS) were also examined in an attempt to identify trends. Results: A tenfold increase in the number of patients attending the ED with primarily mental health problems has occurred over the 10-year period. This is within the context of relatively stable total ED presentations. The increase has been observed in all diagnostic categories although the greatest increase, by percentage, has been for psychotic disorders. A lesser increase was observed for patients presenting with overdose. People presenting with psychotic disorders are also more likely to be detained and admitted. LOS in the ED has also increased along with increasing demand. Conclusions: Reasons for the increased demand are likely multifactorial. While deinstitutionalization and mainstreaming have contributed, the closure of the ED at the local psychiatric hospital does not account entirely for the change. Insufficient community-based mental health services may also contribute to the reasons why people present to the ED and lack of inpatient beds contributes to the increasing LOS experienced in the ED.


2020 ◽  
Author(s):  
Anna Sofie Hansen ◽  
Gry Kjaersdam Telléus ◽  
Christina Mohr-Jensen ◽  
Marlene Briciet Lauritsen

Abstract Background: Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method: In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results: The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion: Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.


1995 ◽  
Vol 29 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Michael Gifford Sawyer ◽  
Robert John Kosky

Approximately 10% of children and adolescents experience mental health problems, however only a small proportion receive specialised help. Identifying approaches which can provide a balanced and effective service for the large number of children and adolescents with problems is currently a major challenge for child and adolescent mental health services in Australia. In South Australia, following a review in 1983, child and adolescent services were reorganised into two separate but closely related services. This paper draws on experience in South Australia over the last decade to identify approaches which can be employed in six key areas that significantly influence the effectiveness of child and adolescent mental health services. The paper also describes the specific features which were included in the South Australian child and adolescent mental health service to address these issues.


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