Goldfinch Christopher, Kochar Amit
Paediatric Emergency, Women's and Children's Hospital, Adelaide, South Australia, Australia.
J Paediatr Child Health. 2022 May;58(5):836-841. doi: 10.1111/jpc.15852. Epub 2021 Dec 13.
Limited recent interstate evidence suggests an increase in paediatric mental health presentations to emergency departments in Australia. We set out to confirm this and whether any specific diagnosis was responsible for this increase.
We identified all patients with mental health presentations aged 6-18 years who attended our tertiary emergency department from January 2006 to June 2019 using our emergency department patient record system. Patients were determined to have a mental health presentation if they had a discharge diagnosis or presenting complaint code that corresponded to a mental health disorder or were referred to the mental health team. For analysis, we divided the 13.5-year duration of our study into three periods of 4.5 years.
Comparing the first and last time periods, there was a 156% increase in mental health presentations over 9 years. This was out of proportion to the increase in combined general and mental health presentations of 11.9%. There was an increase in the proportion of patients who were diagnosed with an adjustment disorder (14-26.6%) or a childhood emotional disorder (8.5-20.8%). Additionally, there was an increase in median wait time and a reduction in the proportion of patients seen within their recommended triage time.
There is a large increase in the number of paediatric mental health presentations to our emergency department. Further resources may need to be allocated to mental health services in the community and in the emergency department.
近期有限的州际证据表明，澳大利亚急诊科收治的儿童心理健康问题有所增加。我们旨在证实这一点，并确定是否有任何特定诊断导致了这种增加。
我们使用急诊科患者记录系统，确定了2006年1月至2019年6月期间在我们的三级急诊科就诊的所有6至18岁有心理健康问题的患者。如果患者有与精神疾病相对应的出院诊断或就诊主诉代码，或者被转诊至心理健康团队，则确定该患者有心理健康问题。为了进行分析，我们将13.5年的研究期分为三个4.5年的时间段。
比较第一个和最后一个时间段，9年间心理健康问题就诊人数增加了156%。这与综合普通和心理健康问题就诊人数11.9%的增长不成比例。被诊断为适应障碍（从14%增至26.6%）或儿童情绪障碍（从8.5%增至20.8%）的患者比例有所增加。此外，中位等待时间增加，在推荐分诊时间内就诊的患者比例下降。
我们急诊科收治的儿童心理健康问题数量大幅增加。可能需要向社区和急诊科的心理健康服务部门分配更多资源。
