Factors associated with repeat emergency department visits for mental health care in adolescents: a scoping review

Rebecca Wilson*, Alice Jennings*, Maria Theresa Redaniel*, Kithsiri B Samarakoon*, Sarah Dawson*, Mark Lyttle*, Jelena Savović*, Behnaz Schofield*

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review


Objectives: The aim of this review was to identify factors associated with multiple visits to emergency department (ED) services for mental health care in adolescents.

Methods: Electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and ProQuest Dissertations & Thesis Global) were searched for evidence that presented an association between risk factors or correlates of multiple visits to the emergency departmental for mental health care by 10–24 year olds. High impact use was defined as at least one return ED visit for mental health care. Primary studies of any quantitative design were included, with no exclusions based on language or country and all possible risk factors were considered. Data were extracted and synthesised using quantitative methods; frequencies of positive, negative and null associations were summarised for categories of potential risk factors.

Results: Sixty-five studies were included in the review. Most studies were from North America and reported a wide range of measures of high impact ED use, the most common being a binary indicator of multiple ED visits. Sex/gender and age were the most frequently reported risk factors. Measure of previous or concurrent access to mental health care was consistently positively associated with high impact use. Having private health insurance, compared with public or no insurance, was generally negatively associated with high impact use. Proxy measures of socioeconomic position (SEP) showed associations between lower SEP and more high impact use in a small number of studies. No other factors were consistently or uniformly associated with high impact use.

Conclusions: The review identified a substantial evidence base but due to the variability in study design and measurement of both risk factors and outcomes, no consistent risk factors emerged. More research is needed, particularly outside North America, using robust methods and high quality routinely collected data
Original languageEnglish
Pages (from-to)23-34
Number of pages12
JournalAmerican Journal of Emergency Medicine
Early online date16 Apr 2024
Publication statusE-pub ahead of print - 16 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024

Structured keywords

  • NIHR ARC West


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