title: Factors associated with a six-month return to emergency services among child and adolescent psychiatric patients.
abstract: OBJECTIVE
  This analysis identified factors associated with emergency department recidivism among pediatric psychiatric patients and factors that may differentiate repeat and one-time visits.
  
  
  METHODS
  The researchers examined six-month recidivism among a sample of 509 patients of ages four to 18 years who made mental health visits to an urban pediatric emergency department in 2004.
  
  
  RESULTS
  Patients who made repeat visits were more likely to be involved in mental health and social services than patients who did not return to the emergency department. Repeat visitors were also more likely to be African American, have a history of psychiatric hospitalization, and present with suicidal or disruptive behaviors.
  
  
  CONCLUSIONS
  These results suggest that the emergency department is being used as part of the continuum of care for patients already in treatment, particularly those displaying disruptive behavior. Additional research is needed to determine whether this recidivism is clinically indicated or reflects a lack of available or appropriate care in community settings.
authors.affiliation: Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD 20892-9633, USA. goldsteinam@mail.nih.gov
authors.forename: Amy B
authors.initials: AB
authors.lastname: Goldstein
authors.forename: Emily
authors.initials: E
authors.lastname: Frosch
authors.forename: Sarah
authors.initials: S
authors.lastname: Davarya
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Leaf
mesh_terms: D000293:Adolescent; D015142:Baltimore; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000517:prevention & control*; D008605:Mental Health Services / Q000706:statistics & numerical data; D012008:Recurrence