Emergency presentations to an inner-city adolescent psychiatric service ELAINE HEALY,SWAROOPA SAHA,FIONA SUBOTSKY AND ERIC FOMBONNE There is little research into emergency presentations in child and adolescent mental health. The purpose of this study was to obtain an overview of number and types of presentations to a inner London child and adolescent mental health emergency service and to determine immediate and longer-term service demands. All available data on 107 consecutive child and adolescent emergency attenders were gathered using a structured data collection sheet. Half of those who presented following an episode of deliberate self-harm were considered to have no mental health disorder though a significant minority of emergency attenders had serious mental health problems. Most attenders were already known to child psychiatry or social services. Prospective study of young people who are already linked in with child mental health and/or social services but who require emergency assessments and interventions is warranted. An understanding of what breaks down in the routine care of these young people would facilitate earlier identification and more effective prevention or early intervention for these vulnerable children and adolescents. r 2002 The Association for Professionals in Services for Adolescents. Published by Elsevier Science Ltd. All rights reserved Introduction Emergency presentations are familiar to all who work in Accident and Emergency Departments and acute paediatric and psychiatric departments. Despite the significant workload associated with these presentations, the high media profile of psychiatric emergencies and their importance as an interface between the community and health care providers, there is little research into emergency services in child and adolescent psychiatry. We decided to review emergency demands on our child and adolescent mental health service in order to: (a) obtain an overview of cases seen; (b) determine service demands at presentation and subsequent service uptake. Methods Sample We defined our sample as young people aged less than 18 years old who presented to our child and adolescent mental health service between 1st January 1997 and 31st December 1997 and were assessed within 24 h of referral. Emergency cases generally present to the emergency clinic of a psychiatric hospital (Maudsley Hospital) or to the Accident & Emergency Department of the adjacent general hospital (King’s College Hospital (KCH)), both services being available 24h per day. During the day, subjects occasionally also present directly to the child and adolescent mental health departments in both hospitals. In addition, Reprint requests and correspondence should be addressed to Elaine Healy, Developmental Psychiatry, E Floor, South Block, Queen’s Medical Centre, Nottingham NG7 2UH, U.K. (E-mail: e.healy@iop.kcl.ac.uk) 0140-1971/02/$3500+000 # 2002 The Association for Professionals in Services for Adolescents. Published by Elsevier Science Ltd. All rights reserved Journal of Adolescence 2002, 25, 397–404 doi:10.1006/jado.2002.0484, available online at http://www.idealibrary.com on