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Assessment of mental health presentations to the paediatric emergency department: a poorly standardised process
  1. Michael Malley1,
  2. Matthew Hall2,
  3. Georgia Parry3,
  4. Hannah Sutton4,
  5. Megan Costelloe4
  1. 1 Children's Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
  2. 2 Paediatric Department, Gloucestershire Royal Hospital, Gloucester, Gloucestershire, UK
  3. 3 Department of Paediatrics, Wrexham Maelor Hospital, Wrexham, UK
  4. 4 Department of Paediatrics, University of Bristol Medical School, Bristol, UK
  1. Correspondence to Dr Michael Malley, Paediatric Emergency Department, Bristol Royal Hospital for Children, Bristol BS2 8BJ, Bristol, UK; michaelkmalley{at}

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Children and young people (CYP) frequently present to paediatric emergency departments (PEDs) in mental health (MH) crises.1 Suicide is one of the leading UK causes of CYP death, while the prevalence of MH issues rose from 10.8% to 16% in 7–16 years old between 2017 and 2020.1

An accurate, objective and standardised assessment is crucial to stratify risk and facilitate timely, effective and individualised treatment. Recent National Institute for Health and Care Excellence (NICE) guidance discourages the use of rapid assessment matrices (RAMs), increasing reliance on individual clinician expertise.2

We aimed to evaluate MH assessment variability among health care professinoals. Fifty-four staff participated in a tertiary PED seeing 1222 MH presentations annually. Six MH presentations were randomly selected from a 1-month sample generated by searching final diagnosis codes …

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  • Contributors MM devised the project. MM, MH and GP analysed data and wrote submission. MM, MC and HS collected data. All authors agreed on the final text.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.