The emergency department (ED) is increasingly being used for mental health visits by children and adolescents. It is estimated that 21-23% of youth have a diagnosable psychiatric or substance use disorder. Using data from the ED of a tertiary medical center, we examined trends in mental health diagnoses over a 5-year period. In school age children the most prevalent diagnoses were anxiety disorders (28.4%); disorders first usually diagnosed in infancy, childhood, or adolescence (26.5%), and mood disorders (18.6%). High school students were more likely to visit the ED for anxiety disorders (30%). Females (34.5%) presented more for anxiety disorders compared to males (22.7%). Mental health visits and diagnoses were higher during school months (September-May) and lower in the summer months (June-August). The diagnosis trends identified in this study have clinical implications that can contribute to evidence-based restructuring of mental health resources and screenings.
The involuntary hospitalization law provides a means by which love ones, caregivers and healthcare professionals can intervene when a mentally ill patient is a danger to self or others. Our study assessed the knowledge of professionals in one of the Greenville Health System (GHS) emergency department (ED) about the involuntary hospitalization process of mental health patients in South Carolina (SC). An eight item survey on the South Carolina involuntary hospitalization and commitment process was developed and distributed to GHS ED staff including: physicians, physician assistants, nurse practitioners, nurses, social workers and technicians. Our findings indicated that the knowledge base is not consistent across healthcare discipline, nor is it sufficient given that most professionals achieved less than 50% correct response. This study has implications for ongoing education for ED healthcare workers which will be of significant importance to promote beneficence and to uphold the standards of patientcentered practice and compassionate medicine.
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