Scientists have developed a molecular “clock” that could reshape how pediatricians measure and monitor childhood growth and potentially allow for an earlier diagnosis of life-altering development disorders. The research, published this week in PNAS, describes how the addition of chemical tags to DNA over time can potentially be used to screen for developmental differences and health problems in children.
The HEARTSMAP team went on the road last summer and fall to bring better mental health assessment for kids to emergency departments (EDs) across BC. The team visited EDs in the Interior and Northern BC, and provided two-hour on-site training sessions for clinicians on how to use the HEARTSMAP tool. In total, the tool was implemented and evaluated in 50 EDs across the province.
HEARTSMAP is a new online emergency psychosocial assessment and management tool developed by the Divisions of Pediatric Emergency Medicine and Pediatric Psychiatry at BC Children’s Hospital. The project is led by Dr. Quynh Doan, investigator and pediatric emergency physician at BC Children’s Hospital, and associate professor with the UBC Department of Pediatrics.
“HEARTSMAP was designed to recognize kids in urgent need of mental health support, ensuring they get the help they need before it becomes a crisis.”
Dr. Quynh Doan
Part of a larger Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative project, HEARTSMAP was designed to address the need for more accurate and consistent assessment of pediatric mental health issues in the ED. It’s an online tool that allows practitioners to quickly assess a patient and make customized treatment recommendations, based on the measurements and outcomes of the test.
The Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative project is an initiative with the objective of improving the lives of children, youth and families struggling with mental health and substance use issues. It’s supported by the Doctors of BC and the BC Ministry of Health.
According to the Canadian Mental Health Association, 10 to 20 per cent of Canadian youth are affected by a mental illness or disorder, and only one in five kids receives the treatment they need. With limited resources available for diagnosis and treatment of mental illness, families have become increasingly dependent on ED clinicians to assess mental health concerns.
“Increased visits by kids to the emergency department for mental health issues are a big concern for families and clinicians,” states Dr. Doan, “particularly because inconsistent assessments may not result in the right kind of care. HEARTSMAP was designed to recognize kids in urgent need of mental health support, ensuring they get the help they need before it becomes a crisis.”
HEARTSMAP provides questions to guide clinicians in patient assessment. The tool collects information in several areas, including home life, school and other activities, bullying, thoughts and anxiety, abuse and access to community resources. It uses the data it collects to flag areas of concern and provide an action-plan to clinicians, such as "consult psychiatry" and "refer to crisis response team".
Tool-triggered recommendations are personalized for each patient. The goal is to empower youth and their families and equip them with the information and community resources they need.
“Not only will the implementation of HEARTSMAP improve the experience of families seeking help for mental health concerns in the ED,” says Dr. Doan, “but it will also improve the experience and confidence of ED clinicians. This tool equips them with a standardized, effective approach to assess the mental-health needs of kids and guides them in choosing the right services. This enables them to provide timely care that is tailored to the specific needs of each patient.”
HEARTSMAP was piloted in 2014 in the BC Children’s Emergency Department. Clinicians provided feedback during the testing phase, which allowed the team to refine the tool’s scoring criteria, add additional sample interview questions and adapt the user interface to improve user experience. The team will continue to evaluate the tool’s functionality in community EDs.
HEARTSMAP is funded by the Specialist Services Committee (SSC), a joint collaborative between Doctors of BC and the BC Ministry of Health.
- Dr. Quynh Doan, Investigator and Pediatric Emergency Physician, BC Children's; Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, UBC
- Dr. Tyler Black, Medical Director, CAPE Unit, BC Children’s; Clinical Assistant Professor, Department of Psychiatry, UBC
- Dr. Garth Meckler, Division Head, Pediatric Emergency Medicine; Associate Professor, Department of Pediatrics, UBC
- Ms. Karly Stillwell, Research Coordinator, Doan Research Team, BC Children’s
- Ms. Jessie Dhillon, Research Coordinator, Doan Research Team
- Dr. Alison Lee, Trainee, Doan Research Team and Pediatric Resident, BC Children’s
- Dr. Samara Laskin, Trainee, Doan Research Team and Pediatric Resident, BC Children’s
- Mr. Punit Virk, Graduate student, Doan Research Team
- Ms. Erica Koopmans, Graduate student, Doan Research Team Children’s