7 / 7
Note:
June 24-25, 2019 | Philadelphia, USA
Mental Health 2019
Journal of Mental Health and Aging | Volume 3
Page 33
PSYCHIATRY DISORDERS, MENTAL
HEALTH ANDWELLNESS
World Summit on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
alliedacademies.comYEARS
INVOLUNTARY PATIENTS IN THE PEDIATRIC EMERGENCY DEPARTMENT: A
RETROSPECTIVE CHART REVIEW
Gray C, Cloutier P, Thompson B, Chan E, Reid S
and
Beaudry E
University of Ottawa, USA
Objectives:
While a number of studies have compared the characteristics of voluntary and involuntary adult
patients presenting to the Emergency Department (ED), this study is the first Canadian study to examine invol-
untary pediatric patients in the ED. The objective of this study was to compare the demographic, clinical and
clinical management of involuntary and voluntary patients presenting to a pediatric emergency department.
Methods:
A retrospective chart review was completed for all mental health patients presenting to the emer-
gency department at The Children’s Hospital of Eastern Ontario in 2015 (n=1437 patients with 2082 presen-
tations; 58.9% female, age M=14.25, SD = 3.03). The variables extracted include demographic information,
number of ED visits, restraint use and discharge status. Group comparisons were made with parametric and
non-parametric statistics as appropriate. All tests were two-tailed.
Results:
Of the 2082 presentations, 14.6% (n=303) were involuntary (physician order of assessment or police
apprehension under the provincial mental health act). Significant differences were found between groups (in-
voluntary vs voluntary) on demographic, clinical and clinical management variables. Specifically, involuntary
patients were more likely to be female (53.8 vs 44.9%) to be older (15.3 years vs 14.5 years) and to live under
the care of child protection services (21.2% vs 12.0%) than voluntary patients (all p-values <.01). Involuntary
patients were more likely to present with higher triage acuity (97.3% vs 85.2%) have repeat visits to the ED
(38.9% vs 29.6%) to require restraint (15.5% vs 3.7%) to obtain a consultation from psychiatry-on-call (59.4%
vs 25.0%) and to be admitted to the psychiatric inpatient unit (34.5% vs 10.6%) than voluntary patients (all
p-values <0.01).
Conclusions:
Involuntary status among pediatric patients presenting with psychiatric and behavioral com-
plaints can serve as a marker for acute mental illness that is more likely to require increased access to psychiat-
ric consultation and admission to hospital. In two-thirds of patients, however, discharge can be accomplished
following emergency department mental health assessment. Further study of this population will identify fac-
tors that may allow for more appropriate allocation of resources.
J Ment Health Aging 2019, Volume 3