Outpatient Emergency Admissions to a Child and Adolescent Psychiatry Hospital, and Following Immediate Hospitalization

Objective: The aim of this study was to provide data on child and adolescent psychiatric emergencies focusing on factors leading to immediate hospitalization. Method: A half-year sample consisting of 306 consecutive outpatient emergencies at a large general child and adolescent psychiatric hospital in Germany was examined. Results: 85.3% of the presented patients were aged 13 years or older. 54.6% of the emergencies were presented outside usual working hours. The number of emergencies was higher on weekdays compared to weekends/holidays (p<.001) and higher during school year weekdays compared holidays (p<.01). Self-harm (80.1%) was the main reason for presentation. 45% of male, but only 13% of female patients were presented for potential dangerousness to others. Immediate hospitalization following the emergency contact was more common in 65.2% outside usual working hours, compared to 40.1% at regular hours (p<.001). Persons in charge of legal custody present at the emergency contact made treatment alternatives to immediate admission more probable outside regular working hours (p<.001). Among patients not being hospitalized, 65.5% were offered at least a second contact to the outpatient department of the clinic and 16% were assessed to need help from the youth welfare system. Conclusion: Emergencies to child and adolescent psychiatry show a complex pattern. Hospitalization depends not only on psychopathology, but also on contextual non-psychiatric factors (German J Psychiatry 2013; 16(1): 1-6).