Pediatric Mental Health Concerns in the Emergency Department
Bibliographic record
Abstract
OBJECTIVES: The main purpose of this research was to identify the perceived mental health (MH) concerns of caregivers and youths who present to the emergency department (ED) for MH services. The concordance between caregiver and youth perceptions and clinician ratings of MH concerns were evaluated. Expectations for the visit and perceived stressors that triggered the event are described. METHODS: This study consisted of 241 youths accompanied by caregivers presenting to the ED for MH concerns requiring crisis intervention services. The Caregiver Perception Survey and Youth Perception Survey were completed. These surveys were designed to identify the caregivers' and youths' main concerns and perceived stressors, as well as their expectations in coming to the pediatric ED. A chi analysis was conducted to determine the percentage of agreement of reported MH concerns between groups (youth, caregiver, and clinician), and kappa statistics are reported. RESULTS: Caregivers' and youths' top 5 concerns were suicide ideation, depression or mood, suicidal attempt, anxiety, and self-injury. The top 3 stresses identified by both youths and their caregivers were school, issues with parents, and problems with friends/peers. The top 3 expectations that were noted by caregivers were help/guidance for child, assessment/ evaluation/diagnosis, and health care professional resources. Concordance rates between caregivers and youths for the top 5 concerns ranged from 39.4% to 80.6%. Concordance rates between clinician rating of concerns (as requiring some or immediate action) and caregiver concerns ranged from 18.4% to 45.2%. Concordance rates between clinician and youth ranged from 11.1% to 59.4%. CONCLUSIONS: The top 5 caregivers and youths' main concerns for coming to the ED were similar. However, concordance between perceived concern and clinician assessment is low. Caregivers' expectations for coming to the ED highlight their lack of knowledge of referral procedures and MH services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".