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Community and Service

Research in the Division of Child and Adolescent Psychiatry

Child Psychiatry Consultation to the Pediatric Emergency Department

Principal Investigator: Patrick Kelly, M.D.

Over the last 10 years, we have been tracking demographic and clinical characteristics on all consultations completed by child psychiatry residents in the Pediatric Emergency Department (PED).In addition to an overall marked increase in total volume of cases seen in the PED which parallels the national trend, there has been a marked increase in use of the PED by patients who have prior mental health service events--e.g. prior PED visits, prior hospitalizations, prior suicide attempts, and ongoing outpatient care. The aim of the current project is to clarify which patients are using which services so that we can better develop more targeted interventions both prior to PED use and in the PED and further characterize which patients are seeking care in that setting. It is our hypothesis that there has not been an increase in the number of patients for whom the term "emergency" is typically applied--suicide attempt and psychosis, but rather the increase in use of the PED will be accounted for by aggressive/disruptive youth who have exacerbations of chronic problems.

Child Psychiatry Consultation in Pediatric Primary Care

Principal Investigator: Patrick Kelly, M.D.

The Harriet Lane Clinic (HLC) provides primary pediatric care to 7,000 kids each year, in over 20,000 visits. Most of those families are from the local East Baltimore area and face a number of obstacles to accessing care. Part of the HLC vision is to provide a "one stop shoppin g" model of care for these youngsters and families. Grants from Straus and Blaustein Foundations now support both a full time mental health screener as well as a part time treatment provider. The primary aim of the project is to track clinical and demographic characteristics of the patients that the screener sees and which cases land in the CMHC so that we can better identify who needs which type of referral at the front end to optimize the chances that the patient and families make a connection to mental health services. In addition, we surveyed the pediatric housestaff about their knowledge/skills/attitudes about mental health issues in their patients prior to providing the screening/referral service. We will be following up on that survey to see if there is any change in knowledge/skills/ attitudes with the new teaching/consultation services in place.

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