caa a22 4500 605476721 CHVBK 20210128100357.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00787-014-0618-8 doi (NATIONALLICENCE)springer-10.1007/s00787-014-0618-8 Characteristics and disposition of youth referred from schools for emergency psychiatric evaluation [Elektronische Daten] [Eugene Grudnikoff, Tolga Taneli, Christoph Correll] We aimed to describe the characteristics and disposition of youth referred from schools to the emergency department (ED) for psychiatric evaluations. Consecutive 12-month records of ED psychiatric consultations at a large urban hospital from 07.01.2009 to 06.30.2010 were retrospectively analyzed. School-initiated referrals were deemed inappropriate if youth were discharged from the ED without any recommended mental health follow-up. Of the 551 psychiatric ED evaluations, 243 (44.1%) were initiated by schools. Of all school referrals, only 19 (7.8%) children were psychiatrically hospitalized, 108 (44.4%) were discharged from the ED with a follow-up appointment; and 116 (47.7%) were discharged without arranged follow-up. Those with a chief complaint of "suicidality” (n=109, 44.9%) were more likely to be discharged without arranged follow-up than youth with other presenting complaints (56.0 vs. 41.0%, p=0.021). Altogether, only 37 (18.5%) of 200 school-referred youth with information were evaluated by a school nurse, social worker, or other professional before being sent to the ED. Students without in-school screening were significantly more frequently discharged without follow-up than students with in-school evaluations prior to the ED referral (51.5 vs. 27.0%, p=0.0070; odds ratio=2.87 (95% CI 1.30-6.31). Multivariate predictors of inappropriate school referrals of youth discharged without any outpatient follow-up were higher Children's Global Assessment Scale score (p<0.0001), absent in-school evaluation (p=0.0069), absent prior psychiatric history (p=0.011) and absent current psychotropic medication treatment (p=0.012) (r 2=0.264%, p<0.0001). Altogether 44.1% of ED consultations were school referred, of which 47.7% were potentially inappropriate for the emergency setting. In-school screening, which occurred infrequently, reduced unnecessary evaluations by 52%. Springer-Verlag Berlin Heidelberg, 2014 Emergency nationallicence Psychiatric evaluation nationallicence Children and adolescents nationallicence School referral nationallicence Appropriateness nationallicence Suicidality nationallicence Pediatric nationallicence Grudnikoff Eugene Department of Psychiatry, The Zucker Hillside Hospital, 75-59 263rd Street Glen Oaks, 11004, Glen Oaks, NY, USA aut Taneli Tolga Division of Child and Adolescent Psychiatry, Department of Psychiatry, Rutgers University-NJMS, Newark, NJ, USA aut Correll Christoph Department of Psychiatry, The Zucker Hillside Hospital, 75-59 263rd Street Glen Oaks, 11004, Glen Oaks, NY, USA aut European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/7(2015-07-01), 731-743 1018-8827 24:7<731 2015 24 787 https://doi.org/10.1007/s00787-014-0618-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00787-014-0618-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grudnikoff Eugene Department of Psychiatry, The Zucker Hillside Hospital, 75-59 263rd Street Glen Oaks, 11004, Glen Oaks, NY, USA aut NATIONALLICENCE 700 1- Taneli Tolga Division of Child and Adolescent Psychiatry, Department of Psychiatry, Rutgers University-NJMS, Newark, NJ, USA aut NATIONALLICENCE 700 1- Correll Christoph Department of Psychiatry, The Zucker Hillside Hospital, 75-59 263rd Street Glen Oaks, 11004, Glen Oaks, NY, USA aut NATIONALLICENCE 773 0- European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/7(2015-07-01), 731-743 1018-8827 24:7<731 2015 24 787