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Pediatric Mental Health Concerns in the Emergency Department

一致性 医学 心理健康 急诊科 自杀意念 自杀预防 焦虑 精神科 萧条(经济学) 职业安全与健康 毒物控制 压力源 心情 伤害预防 干预(咨询) 临床心理学 医疗急救 经济 病理 宏观经济学 内科学
作者
Paula Cloutier,Allison Kennedy,Heather Maysenhoelder,Elizabeth Glennie,Mario Cappelli,Clare Gray
出处
期刊:Pediatric emergency care [Ovid Technologies (Wolters Kluwer)]
卷期号:26 (2): 99-106 被引量:55
标识
DOI:10.1097/pec.0b013e3181cdcae1
摘要

Objectives: The main purpose of this research was to identify the perceived mental health (MH) concerns of caregivers and youths who present to the emergency department (ED) for MH services. The concordance between caregiver and youth perceptions and clinician ratings of MH concerns were evaluated. Expectations for the visit and perceived stressors that triggered the event are described. Methods: This study consisted of 241 youths accompanied by caregivers presenting to the ED for MH concerns requiring crisis intervention services. The Caregiver Perception Survey and Youth Perception Survey were completed. These surveys were designed to identify the caregivers' and youths' main concerns and perceived stressors, as well as their expectations in coming to the pediatric ED. A χ2 analysis was conducted to determine the percentage of agreement of reported MH concerns between groups (youth, caregiver, and clinician), and κ statistics are reported. Results: Caregivers' and youths' top 5 concerns were suicide ideation, depression or mood, suicidal attempt, anxiety, and self-injury. The top 3 stresses identified by both youths and their caregivers were school, issues with parents, and problems with friends/peers. The top 3 expectations that were noted by caregivers were help/guidance for child, assessment/ evaluation/diagnosis, and health care professional resources. Concordance rates between caregivers and youths for the top 5 concerns ranged from 39.4% to 80.6%. Concordance rates between clinician rating of concerns (as requiring some or immediate action) and caregiver concerns ranged from 18.4% to 45.2%. Concordance rates between clinician and youth ranged from 11.1% to 59.4%. Conclusions: The top 5 caregivers and youths' main concerns for coming to the ED were similar. However, concordance between perceived concern and clinician assessment is low. Caregivers' expectations for coming to the ED highlight their lack of knowledge of referral procedures and MH services.
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