Are the Mental Health Concerns of Youth Presenting to an Emergency Department More Scute or Severe than Those Waiting for Outpatient Care?

Abstract

BackgroundMental health patients presenting to the emergency department (ED) are potentially more unwell than those waiting for mental health services on outpatient waitlists. They often receive prioritized mental health follow up care, yet this practice may be unjustified if they do not have greater severity and acuity of mental illness.ObjectiveAdolescent mental health patients from an outpatient waitlist sample are compared to those who attended the ED to seek help but were not admitted to hospital.MethodAdolescents completed intake questionnaires at time of outpatient (regular or post ED) intake visit at a pediatric hospital in Canada. Statistical comparisons between the groups were completed on multiple measures of demographic and clinical features.ResultsThe ED group reported more substance use, higher psychiatric symptom severity scores for ODD, ADHD, and MDD, more recent self-harm, suicidal ideations and suicide attempts and lower general functioning. They also reported more ethnic diversity.ConclusionThe greatest differences were seen on measures of suicide risk acuity and substance use, which suggests outpatient interventions immanently focussed on these targets for ED attenders. Considering the high amount of suicide risk, despite lower acuity, in the outpatient wait list sample, future studies should investigate how to most equitably service these two populations.