title: The HEADS-ED: a rapid mental health screening tool for pediatric patients in the emergency department.
abstract: OBJECTIVE
  The American Academy of Pediatrics called for action for improved screening of mental health issues in the emergency department (ED). We developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial history in adolescents. The reliability and validity of the tool and its potential for use as a screening measure are presented.
  
  
  METHODS
  ED patients presenting with mental health concerns from March 1 to May 30, 2011 were included. Crisis intervention workers completed the HEADS-ED and the Child and Adolescent Needs and Strengths-Mental Health tool (CANS MH) and patients completed the Children's Depression Inventory (CDI). Interrater reliability was assessed by using a second HEADS-ED rater for 20% of the sample.
  
  
  RESULTS
  A total of 313 patients were included, mean age was 14.3 (SD 2.63), and there were 182 females (58.1%). Interrater reliability was 0.785 (P < .001). Correlations were computed for each HEADS-ED category and items from the CANS MH and the CDI. Correlations ranged from r = 0.17, P < .05 to r = 0.89, P < .000. The HEADS-ED also predicted psychiatric consult and admission to inpatient psychiatry (sensitivity of 82% and a specificity of 87%; area under the receiver operator characteristic curve of 0.82, P < .01).
  
  
  CONCLUSIONS
  The results provide evidence to support the psychometric properties of the HEADS-ED. The study shows promising results for use in ED decision-making for pediatric patients with mental health concerns.
authors: Department of Mental Health, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1 Canada. cappelli@cheo.on.ca
authors: Mario
authors: M
authors: Cappelli
authors: Clare
authors: C
authors: Gray
authors: Roger
authors: R
authors: Zemek
authors: Paula
authors: P
authors: Cloutier
authors: Allison
authors: A
authors: Kennedy
authors: Elizabeth
authors: E
authors: Glennie
authors: Guy
authors: G
authors: Doucet
authors: John S
authors: JS
authors: Lyons
mesh_terms: D000124:Achievement; D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009864:Ontario; D010379:Peer Group; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012931:Social Environment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D059020:Suicidal Ideation