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Reframing paediatric mental health screening and assessment in emergency care through a biopsychosocial lens: A call
Kristina Maximous1, Sonja Maria1, Andreia Schineanu2
1Charles Sturt University, School of Nursing, Paramedicine and Health Sciences, Panorama Ave, Bathurst, NSW 2795, Australia.
Insights
Pediatric mental health screening tools are lacking in emergency care, especially for paramedics. Development of biopsychosocial (BPS)-informed tools is crucial for equitable child mental health services.
Area of Science:
- Pediatric emergency medicine
- Mental health screening
- Biopsychosocial assessment
Background:
- Pediatric mental health crises are a growing global emergency care challenge.
- Emergency settings are critical for identifying children in psychological distress.
- Current approaches lack holistic methods and validated tools, leading to missed interventions.
Purpose of the Study:
- To conduct a scoping review of screening and assessment tools for pediatric mental health in emergency care.
- To evaluate the alignment of existing tools with the biopsychosocial (BPS) model.
- To identify barriers to implementing these tools in paramedicine.
Main Methods:
- Scoping review following Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines (2004-2024).
- Included studies focused on validated screening/assessment tools for children (0-19) in emergency settings.
- Thematic analysis using a biopsychosocial (BPS) lens.
Main Results:
- 21 screening and 10 assessment tools identified, primarily in hospital emergency departments; none used in paramedicine.
- Only five tools incorporated a BPS model.
- Barriers included time, training, care continuity, and inclusivity issues.
Conclusions:
- An urgent need exists for BPS-informed, developmentally appropriate tools for paramedics.
- Tailored tools are essential to enhance equitable, child-centered emergency mental health care.
- Addressing implementation barriers is key for effective pediatric mental health screening.
Background:
Paediatric mental health crises are an escalating burden in global emergency care, with suicide the second leading cause of death among 10-19-year-olds. Emergency settings often represent the first point of contact for children in psychological distress. However, fragmented implementation, limited use of holistic approaches, and an absence of validated screening tools in paramedicine, contribute to missed opportunities for early intervention.
Methods:
This scoping review followed the Joanna Briggs Institute (JBI) methodological framework and PRISMA-ScR guidelines and sourced literature from key databases from 2004 to 2024. Included studies involved validated screening or assessment tools for children aged 0-19 used in emergency care contexts. Data were extracted, charted, and thematically analysed using a biopsychosocial (BPS) lens to evaluate tool design, clinical feasibility, and relevance.
Results:
Thirty studies met inclusion criteria, identifying 21 screening and 10 assessment tools, mainly used in hospital-based emergency departments. None were applied in paramedicine. Only five tools aligned with the BPS model. Key barriers included time constraints, training deficits, care discontinuity, and limited inclusivity for culturally and linguistically diverse or neurodivergent populations.
Conclusion:
There is an urgent need for BPS-informed, developmentally appropriate tools tailored for paramedic use to improve equitable, child-centred emergency mental health care.
