Profile of paediatric mental health presentations to Australian emergency departments in 2018.

2025-10-20

Newberry-Dupe, Jackson

John-White, Marietta R

Babl, Franz E

Borland, Meredith L

Bourke, Elyssia M

Brownlea, Sandra

Buntine, Paul

Charters, Brooke

Coleman, Mathew

Dunlop, Tahnee

Gaitsgory, Olga

George, Shane

Kochar, Amit

Melvin, Glenn A

Tham, Doris

Tonge, Bruce

Tran, Viet

Craig, Simon

Borschmann, Rohan

Medicine, Dentistry and Health Sciences, The University of Melbourne School of Population and Global Health, Parkville, Victoria, Australia jackson.newberry-dupe@monash.edu.

Centre for Adolescent Health, Murdoch Children's Research Institute Population Health Theme, Parkville, Victoria, Australia.

Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.

Paediatric Emergency Department, Monash Medical Centre, Clayton, Victoria, Australia.

Emergency Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Department of Paediatrics and Critical Care, University of Melbourne, Parkville, Victoria, Australia.

Emergency Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.

Divisions of Emergency Medicine and Paediatrics, School of Medicine, The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia.

Emergency Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Emergency Department, Grampians Health Ballarat, Ballarat, Victoria, Australia.

Emergency Department, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.

Emergency Medicine Research Group, Eastern Health, Box Hill, Victoria, Australia.

Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.

Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland, Australia.

School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia.

The University of Western Australia Rural Clinical School of WA, Albany, Western Australia, Australia.

WA Country Health Service, Albany, Western Australia, Australia.

Centre for Rural Emergency Medicine, Deakin University, Melbourne, Victoria, Australia.

Emergency Department, South West Healthcare, Warrnambool, Victoria, Australia.

Frankston Emergency Department, Peninsula Health, Frankston, Victoria, Australia.

Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland, Australia.

School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia.

Paediatric Emergency Department, Women's and Children's Hospital Adelaide Emergency Services, North Adelaide, South Australia, Australia.

SEED Lifespan, Deakin University School of Psychology, Burwood, Victoria, Australia.

Sunshine Hospital Emergency Department, Western Health, Footscray, Victoria, Australia.

Centre for Developmental Psychiatry and Psychology, Monash University Department of Psychiatry, Clayton, Victoria, Australia.

Royal Hobart Hospital, Tasmanian Health Service THS, Hobart, Tasmania, Australia.

Tasmanian Emergency Medicine Research Institute, Tasmania Department of Health, Hobart, Tasmania, Australia.

Department of Paediatrics, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia.

Paediatric Emergency Department, Monash Medical Centre Clayton, Clayton, Victoria, Australia.

Centre for Mental Health and Community Wellbeing, The University of Melbourne School of Population and Global Health, Parkville, Victoria, Australia.

Centra for Adolescent Health, Murdoch Children's Research Institute Population Health Theme, Parkville, Victoria, Australia.

emergency departments

mental health

pediatrics

remote and rural medicine

self harm

Humans

Female

Male

Emergency Service, Hospital

Adolescent

Child

Retrospective Studies

Australia

Mental Disorders

Child, Preschool

Infant

Health Services Accessibility

Pediatrics

Infant, Newborn

Journal Article

Publication

0000-0002-7933-2133

0000-0002-1107-2187

0000-0001-5617-0955

0000-0003-0406-4493

0000-0003-2594-1643

OBJECTIVES: Paediatric mental health presentations to emergency departments (EDs) are rising. Rural/Regional mental health service users face structural barriers to accessing general and specialist treatment, including physical distance and local service capacity and funding constraints. However, differences in patient characteristics and treatment pathways between major city and rural/regional EDs remain unclear. This study aimed to compare demographic and clinical profiles of paediatric mental health patients within each location. METHODS: Retrospective cohort study of paediatric (aged 0-17 years) mental health presentations at 23 Australian EDs (metropolitan=18, rural/regional=five) from 1 January to 31 December 2018. At each site, up to 100 randomly selected unique patient medical records were included. Demographic and clinical characteristics were compared using logistic and linear mixed effects regression models. RESULTS: 2234 young people were recruited (metropolitan=1803, rural/regional=431). Mean age was 14.4 years (SD=2.6) and 59.4% were female. Frequent presentation reasons were suicidal ideation (853; 38.2%), self-harm (668; 29.9%) and behavioural disturbance (306; 13.7%). Of those with complete documentation, 703 (70.9%) had family history of mental illness and 933 (41.8%) reported recent interpersonal difficulties (eg, family/peer conflict). Three hundred and twenty-nine young people (14.7%) were admitted and 1024 (45.8%) were referred to public child and adolescent mental health services (CAMHS). Patients in rural/regional settings had shorter median waiting times for ED clinicians (24 vs 42 min) and mental health assessments (1.1 vs 2.5 hours), shorter median ED length of stay (2.9 vs 4 hours) and higher likelihood of referral to CAMHS on discharge (OR 2.19, 95% CI 1.22, 3.93). CONCLUSIONS: Characteristics of children and adolescents presenting with mental health concerns are broadly similar between metropolitan and rural/regional EDs, but treatment characteristics differ. Frequency of family mental illness and interpersonal difficulties highlights the benefits of family focused interventions. Given similar patient profiles, equitable resourcing of rural/regional services is warranted.

link

Emerg Med J . 2025 Oct 20;42(11):712-720. doi: 10.1136/emermed-2024-214729.

1472-0213

1472-0213

https://pubmed.ncbi.nlm.nih.gov/40846468/?otool=iaurydwlib