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Objectives: To investigate the number of mental health‐related hospitalisations of adolescents (12–17 years) in South Australia by level of contact with the child protection system (0–11 years). Study design: Whole‐of‐population descriptive study; analysis of de‐identified linked administrative data from the Better Evidence Better Outcomes Linked Data (BEBOLD) platform. Setting, participants: Adolescents born in South Australia, 1991–1999; linked SA Department for Child Protection, Admitted Patient Care (SA Health), and South Australian Perinatal Statistics collection (SA Department for Health and Wellbeing) data. Main outcome measures: Proportion of adolescents (12–17 years) hospitalised with mental health‐related diagnoses; proportion of mental health‐related hospitalisations of adolescents, by level of child protection contact (0–11 years) (no contact, notification but not screened in, screened‐in notification but not investigated, investigation but not substantiated, substantiation, and out‐of‐home care). Results: Of 175 115 adolescents born during 1991–1999, 5646 (3.2%) had been hospitalised with mental health conditions, and 27 203 (15.5%) had histories of contact with child protection services. The proportion of adolescents admitted to hospital with mental health‐related diagnoses increased with the level of prior child protection contact, from 3366 of 147 912 adolescents with no contact (2.3%), to 398 of 6645 with notifications (6.0%), to 209 of 1191 who had been placed in out‐of‐home care (17.5%). Contact with child protection services was recorded for 2280 of 5646 adolescents admitted to hospital with mental health‐related diagnoses (40.4%); 4477 of 10 633 mental health‐related hospitalisations (44.9%) were of adolescents with histories of child protection services contact, including 1285 hospitalisations (12.1%) of adolescents for whom substantiated maltreatment (but not out‐of‐home care) was recorded, and 568 hospitalisations (5.3%) of adolescents who had been placed in out‐of‐home care. Conclusion: About 45% of mental health‐related hospitalisations of 12–17‐year‐old adolescents were of people who had had contact with child protection services by the age of 11 years, although only 15.5% of all adolescents had histories of child protection contact. The trauma associated with a history of child protection can have longer term sequelae, and this should be considered when adolescents are hospitalised with mental health conditions. [ABSTRACT FROM AUTHOR]

Children who have 'early contact' with youth justice (YJ) are a group of significant policy interest. Understanding circumstances which precede or co-occur with YJ contact can support the development of preventive investments and inform debates about systemic reform, such as 'raise the age'. Using whole-of-population administrative data from the SA Better Evidence Better Outcomes Linked Data (BEBOLD) platform, we examine differences between children who have early (i.e. between the ages of 10 and 13 years) versus late (i.e. at age 14 or older) YJ contact, relative to the general population. Children born 1991–2022 were followed from birth to age 18 (N = 249,995). Compared to the late-contact group, children with early contact experienced more serious YJ contact (91% versus 59% experienced custody); were more disadvantaged at birth (e.g. 66% versus 45% born into jobless families); had more serious child protection contact by age 10 (26% versus 12% experienced out-of-home care); and experienced mental health-related hospitalisations from ages 12–18 (43% versus 34%). Relative to the general population, both groups were characterised by significant social and economic disadvantage, child protection contact and mental health challenges. The need for investment in early prevention to divert children from the justice system is clear. [ABSTRACT FROM AUTHOR]

Aim: To quantify the frequency of emergency department (ED) presentations and profile the socio‐demographic, health and presentation characteristics of paediatric ED frequent presenters. Methods: A population‐based data linkage study of 55 921 children in the South Australian Early Childhood Data Project aged 0–12 years with 100 976 presentations to public hospital EDs in South Australia. For each child, the total number of recurrent ED presentations during a 364‐day period post‐index presentation was calculated. Frequent presenters were children who experienced ≥4 recurrent ED presentations. We determined the socio‐demographic, health and presentation characteristics by number of recurrent presentations. Results: Children with ≥4 recurrent presentations (4.4%) accounted for 15.4% of all paediatric ED presentations and 22.5% of subsequent admissions to hospital during the 12‐month study period. Compared to children with no recurrent ED presentation, frequent presenters had higher proportions of socio‐economic and health disadvantage at birth. One in two (49.3%) frequent presenters had at least one injury presentation and one (21.3%) in five had at least one presentation related to a chronic condition. Conclusions: Children with ≥4 presentations do not represent the majority of ED users. Nevertheless, they represent a disproportionate burden accounting for 15% of all paediatric ED presentations in a 12‐month period. Frequent presenters were characterised by early socio‐economic and health disadvantage, and childhood injury. Strategies targeting social disadvantage and childhood injury may reduce the burden of ED presentations. [ABSTRACT FROM AUTHOR]