• Harriet Hiscock, Ann-Siobhan Connolly, Katie Dunlop, Prescilla Perera, Rachel O'Loughlin, Stephanie J Brown, David M Krieser, Adam West, Pauline Chapman, Robyn Lawford, and John A Cheek.
• Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2020 Oct 1; 32 (5): 724-730.

ObjectiveVictorian ED data show increased presentations for anxiety and depression in children. We aimed to determine parent-reported factors contributing to these presentations.MethodsQualitative study with parents of children and young people aged 0-17 years who attended one of four EDs across Victoria between October 2017 and September 2018 and received a primary diagnosis of anxiety or depression (excluding self-harm or suicide attempt). Eligible parents completed semi-structured phone interviews, which were audio-recorded and transcribed. Transcripts were coded and qualitatively analysed using thematic analysis.ResultsSeventy parents completed interviews. The average age of children and young people was 14 years (standard deviation 2.4) and 63% (n = 44) identified as female. Thirty (43%) children received a primary diagnosis of depression, compared to 40 (57%) children who received a primary diagnosis of anxiety. The majority of respondents were mothers (n = 59; 84%). Key themes as to why families presented to EDs included: listening to trusted professionals, desperation, a feeling of no alternative, respecting their child's need to feel safe and to rule out a potentially serious medical condition.ConclusionsParents bring their children to the ED for many reasons. Policy makers, managers and clinicians should work with parents to develop alternative approaches that provide families with community-based support, particularly for younger children and after hours, in order to provide an appropriate source of care for children and young people with anxiety and depression.© 2020 Australasian College for Emergency Medicine.

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