Emergency Presentations to an Inner-city Psychiatric Service for Children and Adolescents

Abstract

Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the relevant catchment area. This article presents a cohort study of 466 consecutive consultations that took place in the Amsterdam Child Psychiatric Emergency Service in 2008, with data on clinical, demographic and consultation-related characteristics. A majority of the consultations (51.5%) was related to behavioural problems in the context of heavily strained relationships. A total of 23.4% consultations were related to neglect or abuse. Parental mental illness prompted 12% of the consultations. Psychiatric diagnoses in the child as such were limited. The main Diagnostic and Statistical Manual of Mental Disorders classification was a relational problem (70%). These crises were serious and often necessitated temporary placement. Hospitalisations on a psychiatric ward and/or pharmacological intervention were rare. Regular mental healthcare providers may specifically need to add psychiatric evaluation and treatment strategies when confronted with disruptive disorders. Additional preventive measures and firmer inter-agency collaboration may ameliorate the containment of problems in these children and their families.

Characteristics of Child and Adolescent Psychiatry Consultations at a University Hospital and Accuracy Rates of Recognition of Childhood Psychiatric Diseases by Nonpsychiatry Specialists

“…In this study, the mean age of the children and adolescents for whom a psychiatric consultation was requested was calculated as 12. The rate of psychiatric consultations requested for girls (61.03%) was significantly higher than the rate of psychiatric consultations requested for boys, which is a compatible finding with the results reported in the literature, considering that the reported rates of psychiatric consultations requested for girls' range between 54% and 70% (18,23,(28)(29)(30)(31)(32). It is known that psychiatric referrals are more common in boys in the pre-adolescence period, however that the prevalence of psychopathologies increases in girls as opposed to boys beginning with early adolescence (33).…”

The Safety First Assessment Intervention: A Whole Family Approach for Young People with High Risk Mental Health Presentations

“…Rarely does the distress represent the manifestation of a serious mental illness such as psychosis or a major mood disorder. Similar conclusions were noted by Dil and Vuijk () and Rowland et al. ().…”

Evaluation of child and adolescent psychiatry consultations in a tertiary university hospital

“…Our study results showed that female adolescents were more likely to be referred to child and adolescent psychiatry clinic. The results from this study are parallel to the current literature [14][15][16][17]. This is of particular significance for mental health intervention, due to the increase in emotional and behavioral problems and the onset of psychiatric disorders that arise during adolescence [18].…”