Many adolescents who are treated in emergency departments for deliberately harming themselves do not receive adequate mental health assessments or follow-up community care, according to research published in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
Jeffrey A. Bridge, Ph.D., of the Nationwide Children's Hospital in Columbus, Ohio, and colleagues conducted a retrospective analysis of national Medicaid claims data to determine the rates and adjusted risk ratios (aRRs) for mental health assessments and subsequent care for 3,241 youth aged 10 to 19 treated in emergency departments for deliberate self-harm.
The researchers found that 72.9 percent of patients were discharged into the community; 39 percent of these had a mental health evaluation in the emergency department and 43 percent received follow-up outpatient mental health care. Data showed that follow-up care was directly related to recent outpatient (aRR, 2.58) and inpatient (aRR, 1.33) mental health care and inversely related to Hispanic ethnicity (aRR, 0.78) and residing in an area with medium-to-high poverty rates (aRR, 0.84).
"These findings highlight the need for the development of strategies to promote emergency department mental health assessments, strengthen the training of physicians in pediatric mental health and adolescent suicide prevention, and timely transitions to outpatient mental health care," the authors write.
Two authors disclosed research support grants from major pharmaceutical companies.
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