JMIR Publications

ABSTRACT

Background:

Emergency departments play a central role in crisis management for children and young people’s (CYP) mental health. These acute settings face significant challenges in delivering effective support, such as shortages of mental health specialists, long waiting times, and overcrowding. Digital mental health interventions (DMHIs) may have the potential to expand access to care, bridge service gaps, and alleviate pressure on emergency care settings for CYP experiencing mental health crises.

Objective:

This study aimed to systematically review the current evidence for the acceptability, suitability, feasibility, and cost-effectiveness of digital mental health interventions for CYP applied in emergency care settings.

Methods:

We conducted database searches using APA PsychINFO, EMBASE, MEDLINE and Web of Science from 2015 to 2025. We included quantitative, qualitative, and mixed-methods studies that related to the acceptability, suitability, feasibility, and cost-effectiveness of DMHIs in acute settings. In addition to studies reporting on data from CYP under the age of 25 years, we also included those evaluating data from caregivers and care providers. All selected studies were assessed for quality using the Mixed-Methods Appraisal Tool.

Results:

Overall, 6,778 articles were retrieved from the database searches, of which 13 articles met the inclusion criteria. In total, data from 1,495 patients, 413 caregivers, and 250 care providers were included across studies, excluding one study that did not report sample size for care providers. Mental health presentations included depressive symptoms, violent behaviours, suicidal ideation and attempts, intoxication, and multiple mental health conditions. Interventions included telepsychiatry, phone calls, text messaging services, and computerised interventions. DMHIs were broadly acceptable, particularly for interventions such as telepsychiatry and structured follow-up phone calls. Feasibility, suitability, and cost-effectiveness outcomes were more varied. These were affected by the specific intervention design, emergency care context, heterogeneity in study design, and user characteristics.

Conclusions:

DMHIs show promise in supporting the mental healthcare needs of CYP in emergency care settings. CYP, caregivers, and care providers demonstrated a willingness to use these tools, but careful consideration is needed to improve the suitability and feasibility of these interventions. More diverse studies are needed to explore these findings in differing contexts and to address existing shortcomings, such as the need for co-design with targeting of populations and healthcare providers, to support the implementation of DMHIs in acute healthcare.