Emergency psychiatric care for children and adolescents: factors associated with multiple visits and hospital admissions.

Abstract

Given the increased demand for mental health resources in the child and adolescent population, this study aims to describe the emergency psychiatric care of the children and adolescents and to explore factors associated with multiple visits and hospital admissions. All patients < 18 years of age who visited the psychiatric ED(ED) of a University Hospital in Madrid, Spain, during 2022 were included. Data were collected by the attending psychiatrist upon first 2022 ED visit (index visit) and during any ED revisit. Electronic health records of all included patients were revised to contrast information and complete missing data. Logistic regressions and correlation analyses were used to explore factors associated with multiple ED visits and hospitalisations. N = 397 patients were included. Factors associated with multiple ED visits were: being LGTBQ+, having eating problems, substance use, consulting for psychosis upon first visit, having a history of suicidal behaviour, previous mental health service use or previous hospitalisations, having two or more psychiatric diagnoses, and being diagnosed of eating disorders or depression. Factors associated with hospitalisation include female gender, older age, LGTBQ+, family conflicts, first or second-generation migrants, history of abuse, eating problems, drug use, history of suicidal behaviour, previous mental health service use or previous hospitalisations, psychiatric comorbidity, and eating disorders diagnosis. Identifying predictors that lead to different clinical pathways and use of mental health services can improve clinical outcomes and resource use.