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时间快照:对都柏林儿科联络精神病学服务所有转介进行的为期 1 个月的回顾,这些转介是在急诊科就诊后进行的。

A snapshot in time: a 1-month review of all referrals to paediatric liaison psychiatry services in Dublin following emergency department presentation.

机构信息

Child and Adolescent Psychiatry, University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.

Child and Adolescent Psychiatry, Lucena Clinic, Dublin 6, Ireland.

出版信息

Ir J Psychol Med. 2023 Sep;40(3):378-386. doi: 10.1017/ipm.2021.26. Epub 2021 Apr 28.

Abstract

INTRODUCTION

An emerging picture has seen increasing numbers of young people with mental health crisis attend paediatric emergency departments in Ireland. Following paediatric review, many are referred to in-house paediatric liaison psychiatry (PLP) services. This pilot study describes referral patterns and practice over a 1-month period across three Dublin centres.

METHODS

Case notes of all referrals to PLP were reviewed to extract relevant clinical and administrative data. For those admitted, costs associated with length of stay were estimated. Clinical profile, management and intra-hospital pathway differences were explored.

RESULTS

Fifty-nine young people under 16 years presented to one of the three EDs with an acute MH presentation. The sample consisted of 39 females (66%) with a mean age of 13.7 years. The majority ( = 34, 58%) presented out of hours. A substantial portion of youths presenting ( = 37, 63%) were admitted, and had a mean duration of stay of 4.51 days. There were differences between hospitals in terms of frequency of presentation with self-harm, admission rates and length of stay.

DISCUSSION

Different PLP service configuration, staffing and funding streams may explain some of the differences observed across centres, although the findings should be interpreted with caution given the limited sample size. Standardisation of service provision and management is needed for PLP services. Additional community CAMHS resourcing is needed to support the development of alternative pathways for youth in need of urgent MH review.

摘要

介绍

越来越多的有心理健康危机的年轻人到爱尔兰儿科急诊就诊,这一新兴现象受到了广泛关注。在儿科检查后,许多人被转介到内部儿科联络精神病学(PLP)服务。这项试点研究描述了在三个都柏林中心的一个月期间的转介模式和实践情况。

方法

对所有转介到 PLP 的病例记录进行了回顾,以提取相关的临床和管理数据。对于那些住院的患者,估计了与住院时间相关的费用。探讨了临床特征、管理和院内途径的差异。

结果

59 名 16 岁以下的年轻人因急性心理健康问题到其中一家 ED 就诊。该样本由 39 名女性(66%)组成,平均年龄为 13.7 岁。大多数(=34,58%)在非工作时间就诊。相当一部分年轻人(=37,63%)被收治,平均住院时间为 4.51 天。在就诊频率、住院率和住院时间方面,各医院之间存在差异。

讨论

不同的 PLP 服务配置、人员配备和资金来源可能解释了一些中心之间的差异,但鉴于样本量有限,这些发现的解释应谨慎进行。PLP 服务需要提供标准化的服务和管理。需要额外的社区 CAMHS 资源,以支持为需要紧急心理健康评估的年轻人开发替代途径。

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