Review: The impact of pediatric mental health care provided outpatient, primary care, community and school settings on emergency department use - a systematic review

Child and Adolescent Mental Health
Scott KirklandAmanda S Newton

Abstract

Increases in emergency department (ED) visits for pediatric mental health care point to a need to understand the impact of mental health services in relation to emergency-based care. This systematic review examined the impact of mental health services delivered in outpatient, primary care, community and/or school settings on ED use and costs for ED-based mental health care. Two electronic databases and gray literature were searched. Eligible studies consisted of randomized/controlled clinical trials or cohort studies examining the effects of mental health services on ED use and costs for this care. Two reviewers independently screened the studies for relevance and study quality. Relative risks (RR), risk differences (RD), or mean differences (MD) were calculated for each study's primary outcome with 95% confidence intervals (CI). Meta-analysis was deferred due to substantial heterogeneity. Six studies were included. Overall risk of bias in the studies ranged from low, unclear, to high. The majority of programs had no effect on ED visits for mental health care. A school-based program was found to reduce the risk of ED visits for any reason during use (RD, -8.0%; 95% CI: -15.2%, -0.9%); however, these visits were not specific to ...Continue Reading

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Citations

Feb 1, 2018·Child and Adolescent Mental Health·Andy Cotgrove

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