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Observational study exploring the differences between the number and severity of mental health presentations to a Children’s Emergency Department over a 2-month period during the Covid-19 Pandemic (2020) compared to the same months in 2019. Additionally, exploration of the possible impact of the introduction of a hotline giving clinicians access to 24/7 Children’s and Adolescent Mental Health Services (CAMHS) advice. Methods Identification of mental health presentations in children ≤ 16 years from coded admission data. Data collected included basic demographics, presenting complaint, final diagnosis, mental health Risk Assessment Matrix (RAM) outcome and timings of review, referral and discharge. Results 141 cases were examined (2019 - n = 79, 2020 - n = 62). During the Covid-19 pandemic 18.9% (n = 10) scored high on the RAM and 64.2% (n = 34) scored moderate whilst in 2019, 17.2% (n = 11) scored high on the RAM and 69.4% (n = 38) scored moderate. 2019 data saw 25.3% (n = 20) discharged directly compared to 37.1% (n = 23) in 2020. In 2020, 26 (42.6%) of CAMHS reviews were via telephone compared to nine (12.3%) in 2019. Overnight (20:00-08:00), in 2019, there were 37 (46.8%) presentations, 86.5% (n = 32) of which required admission and in 2020 there were 36 (58.1%) where 75.0% (n = 27) required admission. Conclusion A higher number of presentations was not seen in the CED despite the potentially adverse psychological effects caused by enforced isolation due to Covid-19. The provision of a 24/7 hotline may have contributed to clinician’s decision to discharge, aiding a higher number of out of hours discharges.

P81 Mental Health Presentations to a UK Tertiary Children’s Emergency Department during the Covid-19 Pandemic in 2020 compared to 2019