Emergency Diversion Clinic: Lessons from Southwestern Ontario's Pandemic Response

ABSTRACT

The COVID-19 pandemic has catalyzed unprecedented change in the delivery of child and youth mental health services in Canada. In response to the need to limit in person attendance at emergency departments, we implemented an emergency diversion clinic (EDC) at Children's Hospital in London, Ontario, Canada and report on findings. Methods: A new pathway to access virtual emergency psy-chiatric consultation was established for patients across Southwestern Ontario. The pathway was designed for urgent and emergent emergency department presentations that did not require an inpatient level of care. The clinic was designed to provide psychiatric consultation within 48 hours of emergency department presentation. Results: Although the evaluation of the clinic is in progress, thus far the EDC has served 65 youth. Preliminary data suggests that this represents 60% of all youth who presented to the ER. Patients presented with serious problems that would have normally precipitated hospital admission and the option of rapid follow up served to successfully divert these patients from inpatient admission to ambulatory care. 55% of the patient were referred after serious suicidal or self-injurious behaviour. After EDC assessment, 56% of the patients were connected with community mental health supports. Conclusion: The EDC was successful at diverting patients from emergency/inpatient care and lowered admission rates while helping patient feel more confidence in their safety skills in order to follow up with community providers. An emergency diversion clinic may serve as a useful model to divert and prevent inpatient admissions and rapidly link patients to timely ambulatory care.