title: Mental health visits in a pediatric emergency department and their relationship to the school calendar.
abstract: OBJECTIVE
  Over the past decade, there has been a significant increase in the rate at which children and adolescents present to emergency departments (EDs) with mental health complaints. The goal of the current study was to assess the rate of ED usage for children and adolescents and to determine if there was an association between mental health emergencies and the school year.
  
  
  METHODS
  Retrospective chart review of 719 psychiatric consultations to an urban ED affiliated with an academic medical center. Records of consultations from April 2001 to March 2002 were reviewed and abstracted for variables such as age, sex, time and date of presentation, and psychosocial factors.
  
  
  RESULTS
  Chi2 analyses reveal significant associations between presentation to the ED for a psychiatric complaint and time of day, day of week, and month of year. One-way analyses of variance also demonstrated mean differences in presentations for day of week and month of year.
  
  
  CONCLUSIONS
  The current study supports previous research findings of an association between the school year and child and adolescent mental health emergencies. In the current study, the school year appears to exacerbate childhood problems, as there is a greater frequency of psychiatric emergencies while children are in school. Implications for ED program development and school-based mental health service delivery are reviewed.
authors.affiliation: Department of Mental Health Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1900, USA. agoldste@jhsph.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Goldstein
authors.forename: Mary Alice C
authors.initials: MA
authors.lastname: Silverman
authors.forename: Sheridan
authors.initials: S
authors.lastname: Phillips
authors.forename: Richard
authors.initials: R
authors.lastname: Lichenstein
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000704:Analysis of Variance; D015142:Baltimore / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006786:Hospitals, Urban; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012574:Schools; D013995:Time