Factors associated with repeat emergency department visits for mental health care in adolescents: A scoping review

Wilson, Rebecca; Jennings, Alice; Redaniel, Maria Theresa; Samarakoon, Kithsiri; Dawson, Sarah; Lyttle, Mark; Savović, Jelena; Schofield, Behnaz

Abstract

1.1Objectives
The aim of this review was to identify factors associated with multiple visits to emergency department (ED) services for mental health care in adolescents.
1.2Methods
Electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and ProQuest Dissertations & Thesis Global) were searched for evidence that presented an association between risk factors or correlates of multiple visits to the emergency departmental for mental health care by 10-24 year olds. High impact use was defined as at least one return ED visit for mental health care. Primary studies of any quantitative design were included, with no exclusions based on language or country and all possible risk factors were considered. Data were extracted and synthesised using quantitative methods; frequencies of positive, negative and null associations were summarised for categories of potential risk factors.
1.3Results
Sixty-five studies were included in the review. Most studies were from North America and reported a wide range of measures of high impact ED use, the most common being a binary indicator of multiple ED visits. Sex/gender and age were the most frequently reported risk factors. Measure of previous or concurrent access to mental health care was consistently positively associated with high impact use. Having private health insurance, compared with public or no insurance, was generally negatively associated with high impact use. Proxy measures of socioeconomic position (SEP) showed associations between lower SEP and more high impact use in a small number of studies. No other factors were consistently or uniformly associated with high impact use.
1.4Conclusions
The review identified a substantial evidence base but due to the variability in study design and measurement of both risk factors and outcomes, no consistent risk factors emerged. More research is needed, particularly outside North America, using robust methods and high quality routinely collected data.
Key words: emergency department; high impact ED use; repeat ED visits; adolescent; mental health

• Journal Article Type: Article
• Acceptance Date: Apr 8, 2024
• Online Publication Date: Apr 16, 2024
• Publication Date: Jul 1, 2024
• Deposit Date: Jul 8, 2024
• Publicly Available Date: Jul 9, 2024
• Journal: American Journal of Emergency Medicine
• Print ISSN: 0735-6757
• Electronic ISSN: 1532-8171
• Publisher: WB Saunders
• Peer Reviewed: Peer Reviewed
• Volume: 81
• Pages: 23-34
• DOI: https://doi.org/10.1016/j.ajem.2024.04.018
• Public URL: https://uwe-repository.worktribe.com/output/11891676