G244 The first year of an integrated children's emergency psychiatric service – an impact assessment. (May 2019) - Henderson, DR
Abstract : The numbers of children and young people presenting to the Paediatric Emergency Department (PED) with mental health problems is rising year on year. In 2017 we introduced a Children's and Young Person's Service (CYPS) to help to manage acute mental health crises in the PED. The CYPS team provides access to trained mental health professionals within one hour of referral from PED 7 days a week, from 8am to 9pm. We aimed to assess the impact of this new service We compared retrospectively collected data from the year immediately before service introduction (05/06/2016–04/06/2017) to the year immediately after it was introduced (05/06/2017–04/06/2018). We identified all children and young people who were seen in the PED and who had a discharge diagnosis of a mental health problem that required psychiatric review. We assessed the impact of the new service by comparing admission rates, total number of bed days, estimated costs and re-attendance rates. Our results are presented using descriptive statistics Prior to the introduction of CYPS, 79 out of 136 (58%) attendances were admitted to an inpatient ward. In the year after this number was 106 out of 234 (45%). This represents a 13% reduction in inpatient admissions, or a reduction of 55 inpatient bed days. This reflects a saving in the cost of acute hospital beds of almost £28 000. Re-attendance rates showed a slight increase, with an average attendance rate of 1.1 attendances per patient per year 2016–2017, compared to 1.25 the following year To our knowledge our service is the first children's emergency psychiatric service to be integrated into a PED in the UK. Our service has shown promising results in its first year and has had a direct cost-saving impact. Consideration should also be given to the unmeasured impact of preventing inpatient admissions. In particular we anticipate a reduction in the psychological impact on children, fewer missed school and work days, improved flow through the PED, and increased availability of inpatient beds. Moving forward we anticipate that CYPS will only become an even more integral and necessary part of modern paediatric emergency medicine provision.