First Nations and low-income children visit emergency departments more often for mental health care

June 11, 2012

First Nations children and those from families receiving government subsidies had more return visits to emergency departments for mental health crises than other socioeconomic groups, found a study published in CMAJ (Canadian Medical Association Journal).

"We found that more First Nations children presented to emergency departments for disorders secondary to substance abuse and intentional self-harm than other children, and that, compared with other children, First Nations children returned more quickly to the emergency department and had a longer time before visiting a physician in the post-crisis period," writes Dr. Amanda Newton, Departments of Pediatrics and Psychiatry, University of Alberta, with coauthors.

Emergency departments are often the first access point for children with who have not received care previously or are in crisis. Although some US research has shown a relationship between race, and and more emergency department visits, there is little Canadian information on the topic.

To determine whether sociodemographic factors influence emergency department visits for mental health care, researchers conducted a population-based cohort analysis of 30 656 visits by 20 956 children under 18 years of age to 104 emergency departments in Alberta between Apr. 1, 2002 and Mar. 31, 2008.

During the six-year study period, First nations children represented 6% of the province's pediatric population; children from families receiving welfare made up 3% and children from families receiving government subsidies made up 14%. However, children in these groups had significantly more visits for care than families with no health care subsidy: 13.8% of visits (4230/30 656) were from First Nations children, 6.4% (1972/30 656) from children in families receiving welfare, and 18.7% (5739/30 656) from children in families receiving government subsidies compared with children in whose families did not receive government subsidies.

"Visits to the emergency department for mental health care should be considered a 'stop gap' solution in the full suite of mental health services," write the authors. "For many children, these visits reflect a need for earlier intervention to prevent illness destabilization into crisis."

Across all , more girls and youth aged 15 to 17 years sought emergency compared with boys and other age groups. Anxiety- or stress-related disorders and emotional or behavioural issues from substance abuse were the most common diagnoses.

In addition, children from First Nations families and those receiving government subsidies returned earlier to the emergency department than other demographic groups. Increasing age and an unspecific diagnosis were also factors associated with earlier returns.

"These findings suggest that investments in culturally based, community- and school-based resources targeting the high-risk behaviours seen in the may help to reduce crisis events and foster the use of mental health resources," write the authors.

Explore further: Pediatric emergency department visits for psychiatric care on the rise

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.111697

Related Stories

Pediatric emergency department visits for psychiatric care on the rise

October 14, 2011
Pediatric patients, primarily those who are underinsured (either without insurance or receiving Medicaid), are increasingly receiving psychiatric care in hospital emergency departments (EDs), according to an abstract presented ...

Majority of self-harming adolescents don't receive a mental health assessment in ERs

January 30, 2012
A national study of Medicaid data shows most young people who present to emergency departments with deliberate self-harm are discharged to the community, without receiving an emergency mental health assessment. Even more, ...

ER visits persist for children with mental health problems despite regular outpatient care

June 1, 2011
Johns Hopkins Children's Center scientists have found that having a regular outpatient mental health provider may not be enough to prevent children and teens with behavioral problems from repeatedly ending up in the emergency ...

Three-fold risk of infection for elderly after emergency department visits

January 23, 2012
A visit to the emergency department during nonsummer months was associated with a three-fold risk of acute respiratory or gastrointestinal infection in elderly residents of long-term care facilities, according to a study ...

Recommended for you

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

Fresh fish oil lowers diabetes risk in rat offspring

July 19, 2017
Fresh fish oil given to overweight pregnant rats prevented their offspring from developing a major diabetes risk factor, Auckland researchers have found.

High-dose vitamin D doesn't appear to reduce the winter sniffles for children

July 18, 2017
Giving children high doses of vitamin D doesn't appear to reduce the winter sniffles, a new study has found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.