Citation

Cullen P, Leong RN, Liu B, Walker N, Steinbeck K, Ivers R, Dinh M. BMJ Open 2022; 12(6): e057388.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/bmjopen-2021-057388

PMID

35640990

PMCID

PMC9171221

Abstract

OBJECTIVES: This study aimed to describe mental health emergency department (ED) presentations among young people aged 8-26 years in New South Wales, Australia, and to identify key characteristics associated with higher risk of ED mental health re-presentation. DESIGN, SETTING AND PARTICIPANTS: Retrospective analysis of linked ED data records for mental health presentations between 1 January 2015 and 30 June 2018. MAIN OUTCOME MEASURES: The main outcome was the total number of mental health ED re-presentations within 1 year, following initial presentation. Count regression models were fitted to estimate factors associated with higher likelihood of re-presentations.

RESULTS: Forty thousand two hundred and ninety patients were included in the analyses, and 9713 (~25%) re-presented during the following year; 1831 (20%) presented at least three times. On average, patients re-presented 0.61 times per 365 person-days, with average time until first re-presentation of ~92 days but greatest risk of re-presentation within first 30-60 days. Young people with self-harm or suicidal diagnoses at initial presentation were more likely to re-present. Re-presentations were highest among young people <15 years (IRR 1.18 vs ≥20 years old), female (IRR=1.13 vs male), young people residing outside of major cities (IRR 1.08 vs major cities) and Aboriginal and Torres Strait Islander young people (IRR 1.27 vs non-Indigenous).

CONCLUSIONS: ED mental health re-presentation is high among young people. We demonstrate factors associated with re-presentation that EDs could target for timely, high-quality care that is youth friendly and culturally safe, with appropriate referral pathways into community-based primary and mental healthcare services.

Language: en

Keywords

Humans; Adult; Female; Male; Australia; Adolescent; Retrospective Studies; Young Adult; New South Wales/epidemiology; *Mental Health; MENTAL HEALTH; Child & adolescent psychiatry; *Emergency Service, Hospital; ACCIDENT & EMERGENCY MEDICINE; Paediatric A&E and ambulatory care; PAEDIATRICS