TY  - JOUR
PY  - 2019//
TI  - Changing rates of self-harm and mental disorders by sex in youths presenting to Ontario emergency departments: repeated cross-sectional study
JO  - Canadian journal of psychiatry, The
A1  - Gardner, William
A1  - Pajer, Kathleen
A1  - Cloutier, Paula
A1  - Zemek, Roger
A1  - Currie, Lisa
A1  - Hatcher, Simon
A1  - Colman, Ian
A1  - Bell, Dayna
A1  - Gray, Clare
A1  - Cappelli, Mario
A1  - Duque, Daniel Rodriguez
A1  - Lima, Isac
SP  - 706743719854070
EP  - 706743719854070
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. <br><br>METHODS: This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. <br><br>RESULTS: Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from -0.18 youths/1000/year (confidence interval [CI], -0.24 to -0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 (<i>P</i> < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 (<i>P</i> < 0.001). Females were more likely to have self-harm (<i>P</i> < 0.001) and mental health visits (<i>P</i> < 0.001). Rates of increase after 2009 were greater for females for both self-harm (<i>P</i> < 0.001) and mental health (<i>P</i> < 0.001). <br><br>CONCLUSIONS: Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents' self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.<p />  <p>Language: en</p>
LA  - en
SN  - 0706-7437
UR  - http://dx.doi.org/10.1177/0706743719854070
ID  - ref1
ER  -