Exploring Mental Health Related Emergency Department Visits: Frequency of Recurrence and Risk Factors

This thesis project aims to provide insights into pediatric mental health care and help to improve its current practice. We explore records of mental health related emergency department visits from children and youth. The data are extracted from the provincial health administrative data systems of Alberta. We start with a descriptive data analysis, and then adopt the counting process framework to conduct statistical inference. A generalized (stratified) Cox regression model and a renewal process model are considered. We evaluate the frequency and identify important risk factors with various model specifications. We also account for the gaps of the visit process due to hospitalization. The project presents the estimates of the model parameters via likelihood and partial likelihood approaches. Robust estimates and the non-parametric bootstrap estimates for the standard errors of the parameter estimators are obtained in addition to the likelihood based standard error estimates. We summarize the analysis and outline a few problems for future investigation in the final chapter.