What are the driving factors behind children’s emergency department visits for mental health and substance use concerns?
Growing rates of visits to emergency departments for child mental health and substance use are occurring internationally, with reported increases ranging from 6-10% per year over the last decade. Yet, we lack the knowledge of the particular characteristics that distinguish between children presenting to emergency departments for mental health and substance use concerns and those who do not. This missing information is greatly needed to support evidence informed clinical and policy decision-making to improve children’s mental health and access to services.
A new study led by Dr. Jinette Comeau of King’s University College at Western University in Ontario uses the 2014 Ontario Child Health Study linked with administrative health data to shed light on the sociodemographic, behavioural, and clinical characteristics of children visiting emergency departments for mental health or substance use concerns. The opportunity to pursue this type of study is unique given that the 2014 Ontario Child Health Study is the only Canadian child epidemiological survey linked with administrative health data.
The authors identify older age, clinical need (internalising problems, perceived need for professional help, and suicidal ideation with attempt), and indicators of social disadvantage (low-income and parental immigrant status) as the most important factors that may increase the risk of a mental health or substance use related emergency department visits. The findings highlight an urgent need to address inequities in access to mental health care across service sectors and settings.
Mental health and substance use related emergency department visits are resource intensive and costly. There is also considerable variation in the availability of mental health care across emergency departments, with some children not receiving adequate treatment or care plans. A better understanding of factors associated with the use of emergency departments for mental health and substance use concerns may help to coordinate emergency services for children with urgent care needs, develop clinical pathways that optimise child outcomes, and inform the development and targeting of upstream interventions that have the potential to prevent avoidable emergency departments visits.
Dr. Comeau states, “This study represents a first step toward better understanding the factors that lead to inequities in children’s access to mental health services. Sustained investment in routine population-based data collection on the mental health needs of children with regular linkage to administrative health data is required to generate the evidence policy makers and practitioners need to inform effective and equitable mental health programming for children”.
Dr Jinette Comeau, Associate Professor, Department of Sociology, King’s University College at Western University, Ontario, Canada
Comeau, J., Wang, L., Duncan, L., Edwards, J., Georgiades, K., Anderson, K. K., Wilk, P. and Lau, T. (2023) “Correlates of child mental health and substance use related emergency department visits in Ontario: A linked population survey and administrative health data study”, International Journal of Population Data Science, 8(1). doi: 10.23889/ijpds.v8i1.2152.