Child/Youth Mental Health and Substance Misuse HEARTSMAP Tool
Pediatrics, Psychiatric and Behaviour, Toxicology
- The HEARTSMAP tool is designed to support emergency department (ED) clinicians to conduct an efficient comprehensive psychosocial evaluation for children and youth presenting with mental health and substance misuse concerns. Using guiding questions, the tool collects information across the following 10 variables:
- Education and Activities
- Alcohol and drugs
- Relationships and bullying
- Thoughts and anxiety
- Sexual health
- Professionals and resources
- These 10 variables were selected and developed based on clinical expert opinion and evidence in mental health literature. A compilation of evidence-based mental health references for each HEARTSMAP section is available at http://heartsmap.ca/cme-material/
- The tool summarizes the scores and clinical notes and generates a report outlining recommendations for ED management (e.g. consult psychiatry, refer to crisis response team, etc.). This report can become part of the patient’s medical record.
- The HEARTSMAP tool is now being implemented across British Columbia in collaboration with the health authorities.
- A generalized version of the tool (Open HEARTSMAP) is available to clinicians without access to a health authority network in British Columbia and clinicians in other provinces or territories.
- Note: Registration and training required before use.
Quality Of Evidence?
We are highly confident that the true effect lies close to that of the estimate of the effect. There is a wide range of studies included in the analyses with no major limitations, there is little variation between studies, and the summary estimate has a narrow confidence interval.
We consider that the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. There are only a few studies and some have limitations but not major flaws, there are some variations between studies, or the confidence interval of the summary estimate is wide.
When the true effect may be substantially different from the estimate of the effect. The studies have major flaws, there is important variations between studies, of the confidence interval of the summary estimate is very wide.
The HEARTSMAP tool has been validated prospectively at the BC Children’s Hospital. It was found to have 100% sensitivity in identifying youth who were ultimately hospitalized. HEARTSMAP has been in use at the BCCH emergency department as the standard assessment tool for youth with mental health emergencies since January 2015. HEARTSMAP has since been further tested among a range of ED clinicians who assess and manage youth mental health emergencies in non-pediatric centres (physicians, psychiatric liaison nurses, and social workers). With high inter-user agreement (domain scores k=0.75 to 0.90), HEARTSMAP is reliable for use across emergency healthcare providers from diverse disciplines.
OTHER RELEVANT INFORMATION
HEARTSMAP Tool – online version (only accessible from a Health Authority network)
HEARTSMAP Tool – paper version
Open HEARTSMAP Tool– accessible anywhere with Wi Fi
Example of ED Algorithm (from Quesnel)
Lee A, Deevska M, Stillwell K, Black T, Meckler G, Park D, Eslami A, Doan Q. A psychosocial assessment and management tool for children and youth in crisis. Canadian Journal of Emergency Medicine. 2018 Mar:1-0.
The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of patients in the emergency department. This summary was produced by the BC Emergency Medicine Network and uses the best available knowledge at the time of publication. However, healthcare professionals should continue to use their own judgment and take into consideration context, resources and other relevant factors. The BC Emergency Medicine Network is not liable for any damages, claims, liabilities, costs or obligations arising from the use of this document including loss or damages arising from any claims made by a third party. The BC Emergency Medicine Network also assumes no responsibility or liability for changes made to this document without its consent.
Last Updated Oct 31, 2018
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