Exploring spatio-temporal patterns in emergency department use for mental health reasons from children and adolescents in Alberta, Canada

This project analyses mental health related emergency department visits from children and adolescents in Alberta, Canada to understand the spatio-temporal patterns and identify risk factors. The data are extracted for the period 2002-2011 from the provincial health administrative data systems of Alberta. A descriptive data analysis is presented and then generalized linear models are explored to model the spatio-temporal pattern of the emergency department visit counts. The seasonal effect is examined using seasonal factors, sine and cosine functions and cyclic cubic smoothing splines. The spatial and temporal correlation structures are modelled using autoregressive model of order 1 and conditionally autoregressive model random effects. Demographic risk factors and their association with the frequency of mental health related emergency department visits is examined. Estimates of the model parameters are obtained and model diagnostics are performed to assess the fit of the model. Age, gender and proxy for socio-economic status are found to be important risk factors. The proposed model can be used as a predictive model to help identify regions and groups at a higher risk for mental health related emergency department visits.