Research

• Please click the links below for the current research on evaluating and using the HEADS-ED screening tool.  

HEADS-ED Under 6

Community Settings

• Polihronis, C., Cloutier, P., Robson, S., Beaudin, K., Blackburn, J., Dawson, C., & Cappelli, M. (2025). HEADS-ED Under 6: A clinician-administered mental health and developmental screening and triage tool. Paediatrics & Child Health, 30(4), 312-319. https://doi.org/10.1093/pch/px...

• Polihronis, C., Cloutier, P., Kempe, L., Schryer, J., & Cappelli, M. (2024). The HEADS‐ED under 6: Piloting a new communimetric mental health and developmental screening and triage tool for young children. Infant Mental Health Journal, 45(5), 557-568.
   https://doi.org/10.1002/imhj.2...

• Matheson, K.M., de Schaetzen, C., Sheridan, N., Holahan, A.-L., Vloet, M., Gray, S., Carstens, J., Postl, L., Deren, B., & Pajer, K. (2026). Development of an infant and early childhood mental health service at a tertiary care pediatric hospital: a needs assessment, community case study and logic model creation. Child and Adolescent Psychiatry and Mental Health. https://doi.org/10.1186/s13034...

HEADS-ED 6 and Older

Emergency Department

• Cappelli, M., Zemek, R., Polihronis, C., Thibedeau, N. R., Kennedy, A., Gray, C., … Cloutier, P. (2017). The HEADS-ED: Evaluating the Clinical Use of a Brief, Action-Oriented, Pediatric Mental Health Screening Tool. Pediatric Emergency Care, 1. doi:10.1097/pec.0000000000001180

• MacWilliams, K., Curran, J., Racek, J., Cloutier, P., & Cappelli, M. (2017). Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients. Pediatric Emergency Care, 33(12), 774–780. doi:10.1097/pec.0000000000000651 

• Cappelli, M., Gray, C.E., Zemek, R.L., Cloutier, P., Kennedy, A.M., Glennie, E., Doucet, G., & Lyons, J.S. (2012). The HEADS-ED: a rapid mental health screening tool for pediatric patients in the emergency department. Pediatrics, 130 2, e321-7.

Emergency Department Mental Health Pathways 

• Newton, A. S., Thull-Freedman, J., Xie, J., Lightbody, T., Woods, J., Stang, A., Winston, K., Larson, J., Wright, B., Stubbs, M., Morrissette, M., Freedman, S. B., Ali, S., Alquarashi, W., Burstein, B., Crawford, T., Eaton, A., Freire, G., et al. (2025). Outcomes Following a Mental Health Care Intervention for Children in the Emergency Department. JAMA Network Open, 8(2), e2461972. https://doi.org/10.1001/jamane...

• Lategan, C., Newton, A. S., Thull-Freedman, J., Xie, J., Winston, K., Wright, B., Stubbs, M., & Freedman, S. B. (2025). Child Well-Being and Family Quality of Life During the COVID-19 Pandemic. Child: care, health and development, 51(2), e70063. https://doi.org/10.1111/cch.70063

• Byles, H., Newton, A. S., Xie, J., Winston, K., Cappelli, M., Thull-Freedman, J., Freedman, S. B., & Pediatric Emergency Research Canada (PERC) (2025). HEADS-ED as a Predictor of Hospitalization in Children Seeking Emergency Department Care with Mental Health Concerns. Academic pediatrics, 102845. Advance online publication. https://doi.org/10.1016/j.acap...

• Tucci, A., Cloutier, P., Polihronis, C., Kennedy, A., Zemek, R., Gray, C., Reid, S., Pajer, K., Gardner, W., Barrowman, N., Cappelli, M., & Jabbour, M. (2025). Improving transitions in care for children and youth with mental health concerns: implementation and evaluation of an emergency department mental health clinical pathway. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913...

• Lightbody, T., Thull-Freedman, J., Freedman, S.B. et al. Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department. Can J Emerg Med 25, 326–334 (2023). https://doi.org/10.1007/s43678-023-00476-4

• Freedman, S., Thull-Freedman, J., Lightbody, T., et al. (2020). Introducing an innovative model of acute paediatric mental health and addictions care to paediatric emergency departments: a protocol for a multicentre prospective cohort study. BMJ Open Quality, 9:e001106. doi: 10.1136/bmjoq-2020-001106

• Boylan K. (2019). Helping the families of children with mental health disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 28(1), 2–3.

• Doupnik, S. K., & Fu, A. (2019). Catching up to the Crisis: Opportunities for Pediatric Hospitals to Improve Children's Access to Mental Health Services. Hospital pediatrics, 9(2), 144–145

• Jabbour, M., Hawkins, J., Day, D., Cloutier, P., Polihronis, C., Cappelli, M., … Gray, C. (2018). An Emergency Department Clinical Pathway for Children and Youth with Mental Health Conditions. Child and Adolescent Psychiatric Clinics of North America, 27(3), 413–425. https://doi.org/10.1016/j.chc.2018.02.005

• U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Critical Crossroads Pediatric Mental Health Care in the Emergency Department: A Care Pathway Resource Toolkit. Rockville, Maryland: U.S. Department of Health and Human Services, 2019.

• Roman, S. B.,Matthews-Wilson, A., Dickinson, P., Chenard, D., & Rogers, S. C. (2018). Current Pediatric Emergency Department Innovative Programs to Improve the Care of Psychiatric Patients. Child and Adolescent Psychiatric Clinics of North America, 27(3), 441–454. doi:10.1016/j.chc.2018.02.004

• Jabbour, M., Reid, S., Polihronis, C., Cloutier, P., Gardner, W., Kennedy, A., … Cappelli, M. (2016). Improving mental health care transitions for children and youth: a protocol to implement and evaluate an emergency department clinical pathway. Implementation Science, 11(1). doi:10.1186/s13012-016-0456-9

Primary Care Mental Health Pathways

• Polihronis, C., Ziebell, L., Cloutier, P., Radomski, A., Sundar, P., Leith, S., Stewart, J., & Cappelli, M. (2023). Closing the Referral Loop: Piloting a Clinical Pathway Between Primary Care and Community-Based Mental Health and Addictions Services. Canadian Journal of Community Mental Health, 42(4), 21-47.

• Polihronis, C., Ziebell, L., Cloutier, P., Radomski, A., Sundar, P., & Cappelli, M. (2023). A primary care mental health pathway for children and youth: A mental health services quality improvement initiative in Ontario. Canadian Journal of Community Mental Health, 42(2), 67=74.

Centralized Intake Referral System 

• Robson, S. J., Cloutier, P., Radomski, A., Polihronis, C., Beaudin, K., Blackburn, J., Dawson, C., & Cappelli, M. (2026). Equity and access to a regional child and youth mental health and addiction navigation service: a secondary analysis study. BMC public health, 26(1), 2324. https://doi.org/10.1186/s12889...

• Robson, S. J., Cloutier, P. F., Polihronis, C., Blackburn, J., Dawson, C., & Cappelli, M. (2026). The CASH Bundle: A Standardized Screening Assessment Bundle for Child and Youth Mental Health, Addictions, and Substance Use Health Implemented in a Regional Coordinated Access and Service Navigation Program: L’ensemble CASH : outil normalisé de dépistage pour la santé mentale, les dépendances et la santé liée à l’utilisation de substances chez les enfants et les jeunes, mis en œuvre dans le cadre d’un programme régional coordonné d’accès et de navigation des services. The Canadian Journal of Psychiatry. https://doi.org/10.1177/070674...

• Clark, S. E., Cloutier, P., Polihronis, C., & Cappelli, M. (2019). Evaluating the HEADS-ED Screening Tool in a Hospital-Based Mental Health and Addictions Central Referral Intake System: A Prospective Cohort Study. Hospital Pediatrics, 9(2), 107–114. doi:10.1542/hpeds.2018-0112 

Community Settings 

• McKenzie, A., & O'Brien, D. (2024). The Evolution of Estimated Time of Arrival: The City of Toronto’s CVE Program. Journal For Deradicalization. 39, 94-128. 

• Whitesell & Company (2019). Wellkin Child & Youth Mental Wellness: Walk-in Counseling Mental Health Services Study

• Henderson, J. L., Cheung, A., Cleverley, K., Chaim, G., Moretti, M. E., de Oliveira, C., Hawke, L. D., Willan, A. R., O'Brien, D., Heffernan, O., Herzog, T., Courey, L., McDonald, H., Grant, E., & Szatmari, P. (2017). Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial. BMJ open, 7(2), e014080.

Others use of the HEADS-ED

• Preyde M, Markle R, Watkis A, Aguto M, Parekh S, Heintzman J. (2026). Piloting the Implementation of Intake Assessment Tools and Caregiver Symptom Rating Tools in a Child and Adolescent Outpatient Psychiatry. Psychiatry International. 7(3):135. https://doi.org/10.3390/psychi...

• Kennedy, A., Gray, C., Sheridan, N., Dunn, L., Stewart, J., Drouin, S., Elliott, H., Adeponle, A., Barrowman, N., Sucha, E., Cappelli, M., Norris, M. L., Jabbour, M., & Cloutier, P. (2025). BRAVA: A randomized controlled trial of a brief group intervention for youth with suicidal ideation and their caregivers. Child and Adolescent Psychiatry and Mental Health, 19(1). https://doi.org/10.1186/s13034...

• Completo, S., Guerra, A. T., Coelho, R., Almeida, H. I., & Loureiro, H. C. (2023). HEADS-ED: Translation and adaptation of a mental health pathology screening scale in Portuguese adolescents. Gazeta Médica, 10(4), 272–281. https://www.gazetamedica.pt/in...

• Cloutier, P., Gray, C., Sheridan, N., Silverman, A., Cappelli, M., Zemek, R., Jabbour, M., Reid, S. and Kennedy, A. (2021), Building Resilience and Attachment in Vulnerable Adolescents (BRAVA): a brief group intervention for adolescents with mild-to-moderate suicidal ideation and their caregivers. Child Adolesc Ment Health. https://doi.org/10.1111/camh.12506

• Musindo, O., Bangirana, P., Kigamwa, P., Okoth, R., & Kumar, M. (2018). Neurocognitive functioning of HIV positive children attending the comprehensive care clinic at Kenyatta national hospital: exploring neurocognitive deficits and psychosocial risk factors. AIDS care, 30(5), 618–622. https://doi.org/10.1080/09540121.2018.1426829

• Leon, S. L., Polihronis, C., Cloutier, P., Zemek, R., Newton, A. S., Gray, C., & Cappelli, M. (2019). Family Factors and
  Repeat Pediatric Emergency Department Visits for Mental Health: A Retrospective Cohort Study. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 28(1), 9–20.  

• Wilson, M. P., & Seupal, R. A. (2018). Are There Tools to Screen Children and Adolescents in the Emergency Department With Mental Health and Substance Abuse Issues? Pediatrics/ Systematic Review Snapshot, 71(2), 233-234. 

• Ambrose, A. J., & Prager, L. M. (2018). Suicide Evaluation in the Pediatric Emergency Setting. Child and Adolescent Psychiatric Clinics of North America, 27(3), 387-397.
  

• Newton, A. S., Hartling, L., Soleimani, A., Kirkland, S., Dyson, M. P., & Cappelli, M. (2017). A systematic review of management strategies for children’s mental health care in the emergency department: update on evidence and recommendations for clinical practice and research. Emergency Medicine Journal, 34(6), 376–384. doi:10.1136/emermed-2016-205939

• Newton, A. S., Hartling, L., Soleimani, A., Kirkland, S., Dyson, M. P., & Cappelli, M. (2017). A systematic review of management strategies for children’s mental health care in the emergency department: update on evidence and recommendations for clinical practice and research. Emergency Medicine Journal, 34(6), 376–384. doi:10.1136/emermed-2016-205939

• Kubiel, T. J. (2016). Transforming Care of the Behavioral Health Patient in an Emergency Department Setting

• Chun, T. H., Duffy, S. J., & Linakis, J. G. (2013). Emergency Department Screening for Adolescent Mental Health Disorders: The Who, What, When, Where, Why and How It Could and Should Be Done. Clinical pediatric emergency medicine, 14(1), 3–11. doi:10.1016/j.cpem.2013.01.00

• Canadian Patient Safety Institute & The Mental Heath Commission of Canada (January 2021). Suicide Risk Assessment Toolkit: A Resource for Healthcare Workers and Organizations