To describe a cohort of adolescents presenting to an emergency department with mental health problems.

An Emergency Department (ED) computerized record system and hospital records were used to obtain data on adolescents aged from 12 to 17 years who presented to an ED of a General Hospital with emotional or behavioural problems.

There were 213 presentations of 182 adolescents in a 12-month period. 77% were female, 56% were 16 or 17 years old, 8% did not live with immediate or extended family. There was a wide variety of presenting symptoms including anxiety, self-harm, suicide attempts (14,5% presented with suicidal behaviour), behavioural disorders, depression, eating disorders, acute psychosis, developmental disability, substance abuse. Psychosocial problems were frequent. Medication was prescribed in 38% of the presentations and 7.5% of the cases were admitted to a psychiatry ward. 54% had no previous psychiatric history.

Many adolescents with mental health problems had no previous or current treatment and were referred to local mental health resources for further evaluation. Psychiatric ED evaluations are an opportunity for recognition of risk factors, screening and early intervention in youth with mental health disorders and their management involves collaborative efforts with multidisciplinary services.