Table 1

Summary of included studies

Study; countryDesign; duration of studyObjectivesSetting (annual visits)ED-management strategy: type; features
Cappelli et al 32
Psychometric; 3 monthsTo evaluate the HEADS-EDPaediatric ED, urban tertiary (60 000)Assessment/screening
  • Mnemonic: home, education, activities and peers, drugs and alcohol, suicidality, emotions and behaviour, discharge resources

  • Administered by crisis intervention worker during intake assessment

Donofrio et al 27
Retrospective cohort; 18 monthsTo assess whether screening laboratory tests obtained to medically clear patients altered management or disposition, or changed length of stayPaediatric ED, urban level 1 trauma centre (22 000)Assessment/screening
Screening laboratory tests
  • For medical clearance; vis-à-vis routine history taking and physical examination

  • White blood cells and platelet count; levels of haemoglobin, sodium, potassium, chloride, bicarbonate, blood urea nitrogen, creatinine, calcium, glucose, total bilirubin, alanine and aspartate aminotransferase, and thyroid stimulating hormone; urine pregnancy test; rapid plasma reagent test; urinalysis

Santillanes et al 28; USARetrospective cohort; 18 monthsTo assess the utility of ED medical clearance before transfer of patients on psychiatric holds to inpatient care and to evaluate charges associated with medical clearancePaediatric ED, urban level 1 trauma centre (22 000)Assessment/screening
Medical clearance procedure
  • History and physical examination

  • Laboratory and/or radiological studies based on physician discretion and requirement of accepting psychiatric facility

Grover and Lee 29; USARetrospective cohort; 2 yearsTo evaluate outcomes associated with a 24-hour/day behavioural health unit parallel to the ED to deliver emergency mental health carePaediatric ED, urban tertiary (65 000)Specialised model of care
Behavioural health unit
  • Five camera-monitored rooms with recessed and muted lighting, hospital beds with easily removable chairs, door hinges to allow examination room doors to swing in or out, television behind shatterproof glass, mobile equipment, no sinks, bathroom with safety features and alert button instead of pull cord

  • Staffed by registered nurses, mental health technician, social workers, ED physicians

Mahajan et al 30
Before–after; 5 months before and 7 months afterTo evaluate the impact of a child guidance model on ED visitsPaediatric ED, urban tertiary (90 000)Specialised model of care
Child guidance model
  • Referral to child guidance team (psychiatric social worker and child psychiatrist) for disposition decision making

Parker et al 26
Interrupted time series; 46 monthsTo describe the impact of a rapid response modelGeneral ED, urban (NTD)Specialised model of care
Rapid response model
  • Immediate consultation with child psychiatrist or resident

  • Urgent consultation (reserved appointments)

  • Education

Greenfield et al 31
Before–after; 1 year before and 3 years afterTo determine the impact of an outpatient psychiatric follow-up team on hospitalisation ratePaediatric ED, urban tertiary (NTD)Specialised model of care
Emergency room follow-up team
  • Patient seen by clinical nurse specialist and child psychiatrist after assessment by ED psychiatric staff

  • Family and psychodynamically oriented treatment

  •  NTD, not able to determine.