Research themes and key data points for child and adolescent emergency department mental health presentations: A national Delphi study

Marietta R John-White; Edmund Proper; Frank Muscara; Franz E Babl; Vicki A Anderson; Catherine L Wilson; Meredith L Borland; Bruce J Tonge; Kylie M Gray; Glenn A Melvin; Amit Kochar; Rohan Borschmann; Richard Haslam; Emma J Tavender; Michael S Gordon; Stuart R Dalziel; Karen Smith; Simon S Craig; Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network

doi:10.1111/acem.15056

Research themes and key data points for child and adolescent emergency department mental health presentations: A national Delphi study

Acad Emerg Med. 2024 Dec 2. doi: 10.1111/acem.15056. Online ahead of print.

Authors

Marietta R John-White^{1

2}, Edmund Proper², Frank Muscara^{3

4}, Franz E Babl^{3

4

5}, Vicki A Anderson^{5

6}, Catherine L Wilson^{4

5

7}, Meredith L Borland^{8

9}, Bruce J Tonge¹⁰, Kylie M Gray^{10

11}, Glenn A Melvin^{12

13}, Amit Kochar^{14

15}, Rohan Borschmann^{7

16

17

18}, Richard Haslam⁵, Emma J Tavender^{5

7

19}, Michael S Gordon^{10

20}, Stuart R Dalziel^{21

22}, Karen Smith^{23

24

25}, Simon S Craig^{1

2

3}; Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network

Affiliations

¹ Department of Emergency Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.
² Department of Paediatrics, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
³ Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁴ Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
⁵ Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁸ Department of Emergency Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.
⁹ School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
¹⁰ Department of Psychiatry, Monash University, Melbourne, Victoria, Australia.
¹¹ University of Warwick, Coventry, UK.
¹² Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Melbourne, Victoria, Australia.
¹³ Monash University, Melbourne, Victoria, Australia.
¹⁴ Department of Acute Care Medicine, University of Adelaide, Adelaide, South Australia, Australia.
¹⁵ Department of Emergency Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.
¹⁶ The University of Melbourne, Melbourne, Victoria, Australia.
¹⁷ Department of Psychiatry, University of Oxford, Oxford, UK.
¹⁸ Curtin University, Perth, Western Australia, Australia.
¹⁹ Health Services Research Unit, Royal Children's Hospital, Melbourne, Victoria, Australia.
²⁰ Early in Life Mental Health Service, Monash Health, Melbourne, Victoria, Australia.
²¹ Department of Surgery and Paediatrics, The University of Auckland, Auckland, New Zealand.
²² Emergency Department, Starship Children's Health, Auckland, New Zealand.
²³ Department of Epidemiology and Preventive Health, Monash University, Melbourne, Victoria, Australia.
²⁴ Department of Research and Innovation, Silverchain, Melbourne, Victoria, Australia.
²⁵ Ambulance Victoria, Melbourne, Victoria, Australia.

PMID: 39618244
DOI: 10.1111/acem.15056

Abstract

Objective: The objective was to identify a prioritized list of research themes and key data points (baseline data and research outcomes) for future studies regarding child and adolescent emergency department (ED) mental health presentations.

Methods: A prospective survey-based Delphi process was undertaken in Australia within the Pediatric Research in Emergency Departments International Collaborative (PREDICT) network. Hospital-based and community-based clinicians, researchers, police, ambulance paramedics, pediatric patients, and their carers were recruited to generate research themes and key data points for future pediatric ED mental health research. Responses were collated and analyzed by a steering group consisting of pediatric mental health, medical, and research/academic experts. Participants then prioritized the items through three survey rounds using a 9-point Likert-type scale to generate a final prioritized list.

Results: 184 participants (36 patients/carers and 148 clinicians/researchers) were recruited and generated 267 items for initial prioritization; 23 completed all survey rounds. The surveys identified a consensus of 71 items: 35 research themes and 36 key data points (11 baseline data points and 25 research outcomes) for future research. The top-rated research themes included patient/staff safety within the ED, the efficacy of dedicated mental health spaces, and the importance of patient follow-up. Important baseline data points included risk factors for mental health presentations and history of child abuse and/or family violence. Top-rated research outcomes included the occurrence of severe behavioral disturbance in the ED, the use of parenteral sedation, and ED re-presentation and/or suicide attempt postdischarge.

Conclusions: The Delphi process identified a prioritized list of research themes and key data points that will inform future research on child and adolescent mental health-related ED presentations.

Keywords: adolescent; emergency; mental health; research prioritization.

Abstract

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