6.2 VIRTUAL IN-HOME EMERGENCY DEPARTMENT MENTAL HEALTH CONSULTATIONS FOR CHILDREN AND YOUTH

Gray, Clare

Objectives: The pressures related to the COVID-19 pandemic have resulted in the need to develop innovative ways to deliver mental health (MH) care to patients with emergent needs. This study evaluates the Emergency Department Virtual Care (EDVC) program providing virtual in-home assessments completed by emergency department (ED) physicians for patients with emergent MH needs compared to those seen in person. Methods: We used a mixed-methods design to evaluate the EDVC program with input from patients, caregivers, and ED physicians. Data were collected on those who used or provided in-person or virtual ED services from May 4 through December 31, 2020. Data sources included online surveys, focus groups, and retrospective chart audits. Results: A total of 1499 youth aged 3 to 17 visited the Children’s Hospital of Eastern Ontario (CHEO) ED in person for an MH concern, and 61 booked a virtual appointment. The groups differed in presenting problem (47% depression/suicidal/deliberate self-harm vs 31% anxiety), age (13.75 vs 12.26;p < 0.001), and suicide score on the Home, Education, Activities/peers, Drugs/alcohol, Suicidality, Emotions/behavior, Discharge resources (HEADS-ED;0.843 vs 0.529;p = 0.096). Families who visited the ED in person (n = 67) or who used the EDVC (n = 13) platform responded to the experience survey. Most families (83%) who used EDVC reported a willingness to recommend the platform to others and felt it was as good as an in-person ED visit (66.67%). Two-thirds of the ED physicians who completed the survey (n = 25) reported that patients benefited from EDVC (64%);however, responses were mixed regarding the impact on job satisfaction, with 44% reporting feeling neutral and only 24% reporting a positive impact. Conclusions: ED physicians providing in-home virtual assessments for patients with emergent MH needs have been well received by families who indicated they would use the service again. The EDVC program potentially prevents unnecessary ED visits for patients with MH needs, which is crucial during a pandemic. RCR, TVM, OTH