Characteristics and disposition of youth referred from schools for emergency psychiatric evaluation.
We aimed to describe the characteristics and disposition of youth referred from schools to the emergency department (ED) for psychiatric evaluations. Consecutive 12-month records of ED psychiatric consultations at a large urban hospital from 07.01.2009 to 06.30.2010 were retrospectively analyzed. Sc...
| Publicado en: | European Child & Adolescent Psychiatry Vol. 24; no. 7; pp. 731 - 744 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jul2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109816221&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109816221 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10188827 EJ3 jtl: European Child & Adolescent Psychiatry issn: 10188827 maglogo: N pubinfo: dt: Jul2015 vid: 24 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109816221 103642161 10.1007/s00787-014-0618-8 109816221 ppf: 731 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Characteristics and disposition of youth referred from schools for emergency psychiatric evaluation. aug: au: Grudnikoff, Eugene Taneli, Tolga Correll, Christoph affil: Department of Psychiatry, The Zucker Hillside Hospital, 75-59 263rd Street Glen Oaks Glen Oaks 11004 USA sug: subj: Emergency Services, Psychiatric Pediatric Care Referral and Consultation Character Human Descriptive Statistics Retrospective Design Urban Areas Confidence Intervals Scales Odds Ratio New Jersey Academic Medical Centers Algorithms Analysis of Variance Chi Square Test Data Analysis Software Child Adolescence Male Female Child: 6-12 years Adolescent: 13-18 years Male Female ab: We aimed to describe the characteristics and disposition of youth referred from schools to the emergency department (ED) for psychiatric evaluations. Consecutive 12-month records of ED psychiatric consultations at a large urban hospital from 07.01.2009 to 06.30.2010 were retrospectively analyzed. School-initiated referrals were deemed inappropriate if youth were discharged from the ED without any recommended mental health follow-up. Of the 551 psychiatric ED evaluations, 243 (44.1 %) were initiated by schools. Of all school referrals, only 19 (7.8 %) children were psychiatrically hospitalized, 108 (44.4 %) were discharged from the ED with a follow-up appointment; and 116 (47.7 %) were discharged without arranged follow-up. Those with a chief complaint of 'suicidality' ( n = 109, 44.9 %) were more likely to be discharged without arranged follow-up than youth with other presenting complaints (56.0 vs. 41.0 %, p = 0.021). Altogether, only 37 (18.5 %) of 200 school-referred youth with information were evaluated by a school nurse, social worker, or other professional before being sent to the ED. Students without in-school screening were significantly more frequently discharged without follow-up than students with in-school evaluations prior to the ED referral (51.5 vs. 27.0 %, p = 0.0070; odds ratio = 2.87 (95 % CI 1.30-6.31). Multivariate predictors of inappropriate school referrals of youth discharged without any outpatient follow-up were higher Children's Global Assessment Scale score ( p < 0.0001), absent in-school evaluation ( p = 0.0069), absent prior psychiatric history ( p = 0.011) and absent current psychotropic medication treatment ( p = 0.012) ( r = 0.264 %, p < 0.0001). Altogether 44.1 % of ED consultations were school referred, of which 47.7 % were potentially inappropriate for the emergency setting. In-school screening, which occurred infrequently, reduced unnecessary evaluations by 52 %. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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