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    Child/Youth Mental Health and Substance Misuse HEARTSMAP Tool

    Pediatrics, Psychiatric and Behaviour, Substance Use, Toxicology

    Last Reviewed on Oct 31, 2018
    Read Disclaimer
    By Quynh Doan,Erica Koopmans


    • 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:
      • Home
      • Education and Activities
      • Alcohol and drugs
      • Relationships and bullying
      • Thoughts and anxiety
      • Safety
      • Sexual health
      • Mood
      • Abuse
      • 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?


    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.


    Related Information


    1. HEARTSMAP Tool – online version (only accessible from a Health Authority network)

    2. HEARTSMAP Tool – paper version

    3. Open HEARTSMAP Tool– accessible anywhere with Wi Fi

    4. Example of ED Algorithm (from Quesnel)

    5. HEARTSMAP and the Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative ER protocol

    Reference List

    Relevant Resources


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