What is the culture (i.e., values and beliefs) of a Pediatric Emergency Department (ED) in providing care to children/youth who arrive in the ED primarily for care regarding a mental health concern?

Abstract

Children/youth with mental health concerns are presenting to Pediatric Emergency Departments (ED) at increasing rates. Staff in the ED feel ill equipped to provide care. The introduction of the Emergency Mental Health and Addiction Service (EMHAS) team in the IWK Health Centre ED, gave opportunity to explore the ED culture. This study posed ‘what is the culture (i.e., values and beliefs) of a Pediatric ED in providing care to children/youth who arrive in the ED primarily for a mental health concern?’ Ethnography was used and employed three methods of data collection. Themes reflecting culture emerged: Shared history of Violence: Fear; Environment: Dismissive; Two cultures: Total Opposites but a Common Patient Goal; Shared Ideations, and Seeking Clarity. Themes came together under an overarching theme, Confusion: Seeking Meaning. Introduction of the EMHAS has challenged the ED culture. While this has created confusion, both teams share a common patient goal.