This project focuses on paediatric mental health screening and assessment in the emergency care setting, with particular emphasis on improving paramedic-led care by exploring the applicability of screening tools for use by paramedics
Paediatric mental health crises continue to place a growing burden on emergency care systems worldwide. Suicide remains the second leading cause of death among adolescents aged 10–19 since the 1990s. Emergency settings often represent the first point of contact for children in psychological distress; however, fragmented care, limited use of holistic approaches, and the absence of validated screening tools in paramedicine result in missed opportunities for early intervention.
This scoping review followed the Joanna Briggs Institute (JBI) methodological framework and PRISMA-ScR guidelines, identifying relevant literature from 2004 to 2024. Included studies involved validated mental health screening or assessment tools used with children aged 0–19 in emergency care settings. Data were extracted, charted, and thematically analysed through a biopsychosocial (BPS) lens to assess design, feasibility, and relevance.
A total of 30 studies met the inclusion criteria, identifying 21 screening and 10 assessment tools, predominantly used in hospital-based emergency departments. None were implemented in paramedic practice. Only five tools aligned with a BPS approach. Barriers to implementation included time constraints, inadequate training, discontinuity of care, and limited inclusivity for culturally and linguistically diverse or neurodivergent populations.
Findings highlight an urgent need for BPS-informed, developmentally appropriate tools tailored for use by paramedics to support equitable, child-centred emergency mental health care.
The aim of this scoping review is to identify and map the range of paediatric mental health screening and assessment tools used within emergency care settings
To evaluate their alignment with a biopsychosocial model, and potential applicability to paramedic practice.
PhD Student at Charles Sturt University
This scoping review underscores the urgent need for inclusive, biopsychosocial-informed approaches to paediatric mental health screening in emergency care, particularly within paramedic-led, out-of-hospital settings where validated tools are currently absent. While various instruments exist, their limited use and misalignment with clinical realities highlight the need for systemic integration over isolated tool adoption. The review concludes that screening must be seen as part of a broader continuum of care, not a standalone intervention. Future research should prioritise the adaptation, co-design, and practical testing of the five BPS-aligned tools identified, focusing on their feasibility, clinical relevance, and capacity to enhance care continuity in paramedic practice.