The number of children seeking help from hospital emergency departments for mental health concerns is increasing.

A new trans-Tasman study is hoping to find out why.

The Royal Hobart Hospital (RHH) is one of 30 sites across Australia and New Zealand participating in The Kids Are Not Okay study, run by the Paediatric Research in Emergency Departments International Collaborative.

RHH emergency medicine research director Viet Tran is leading the Tasmanian research.

“What we’re basically looking for are the certain things that might tell us what the risk factors for young people presenting to emergency departments are,” Dr Tran said.

“Things like age, or the social reasons they might have come to hospital for, or what their social situations are like.”

The researchers will also look at how the patients are being managed, while they are within the emergency department and after they leave.

“We understand that there might be a host of factors that are driving these presentations but we do need to understand those elements more deeply, and from there begin to map out what is a better way to support these kids, not just in their presentations at the hospital but subsequently in the community,” RHH Research Foundation chief executive Heather Francis said.

Dr Tran co-authored a paper published last year in the medical journal Emergency Medicine Australasia that looked at all presentations to emergency departments for mental health concerns between 2004-05 and 2016-17.

“What we found, alarmingly, is that for all cases of mental health presentations to EDs, there’s a disproportionate increase compared to anything else,” he said.

“And what’s worrying as well is the fact that for those less than 18 [years] what we’re actually seeing is a two-fold increase in the rate of presentation to emergency departments for that time period.”

Dr Tran said half of mental health concerns appeared before a patient turned 14.

“If you put those two facts together … we’ll see a much larger increase in the number of mental health presentations in adults in the future,” he said.

“If we can work out why this is happening now, as well as how we’re managing it now, then perhaps we can alleviate that in the future.”

‘Important’ research

Black Dog Institute director Helen Christensen said the research was important.

“This year, 2020, has brought together a number of concerns that young people have,” Professor Christensen said.

“We often hear young people are very concerned about climate change and the bushfires themselves have reinforced this idea that our environment is vulnerable, and I think it’s really convincing young people about the importance of the environment and what might confront them in future years.”

She said the COVID-19 pandemic had also exacerbated young people’s fears about their education and employment prospects.

“On top of that, the other major factors that make young people vulnerable are trauma, disrupting relationships, relationship breakdown, parental problems, problems in the home, navigating that very difficult area that young people have to during adolescence. All of those things will often create vulnerabilities.

“That in association with a stressor or a transition will lead to an increase as we see in anxiety, depression and also panic in some ways.”

Professor Christensen said it would be unfortunate if large numbers of young people were going to emergency departments as their first choice.

“We should really be thinking about preventative measures and early intervention measures in these cases. There’s a lot that can be done in schools before kids reach crisis point.”

Global trend, local differences

Each of the sites contributing to the national The Kids Are Not Okay study will help explain the broader situation, but their findings will also be important at a local level.

“We understand that this trend of presentations by kids into ED is global, but we do also appreciate that in every regional location the experience is going to be rather different,” Ms Francis said.

“We do appreciate that there are many who are working really hard to create change in this area. It’s taking a long time, it does demand resources, and it does demand evidence, and that’s part of that gap that we hope to fill.”

The Kids Are Not Okay project will collect data from hospital presentations throughout 2018. The second part of the project, to identify future research priorities, is expected to start early next year.