The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies
Author:
Saidinejad Mohsen1, Duffy Susan2, Wallin Dina3, Hoffmann Jennifer A.4, Joseph Madeline M.5, Uhlenbrock Jennifer Schieferle6, Brown Kathleen7, Waseem Muhammad8, Snow Sally9, Andrew Madeline10, Kuo Alice A.11, Sulton Carmen12, Chun Thomas13, Lee Lois K.14, Conners Gregory P., Callahan James, Gross Toni, Joseph Madeline M., Lee Lois K., Mack Elizabeth, Marin Jennifer, Mazor Suzan, Paul Ronald, Timm Nathan, Cicero Mark, Dietrich Ann, Eisenberg Andrew, Fallat Mary, Tellez Sue, Dietrich Ann M., Alade Kiyetta H., Amato Christopher S., Atanelov Zaza, Auerbach Marc, Barata Isabel A., Benjamin Lee S., Berg Kathleen T., Chang Cindy, Chow Jessica, Chumpitazi Corrie E., Claudius Ilene A., Easter Joshua, Foster Ashley, Fox Sean M., Gausche-Hill Marianne, Gerardi Michael J., Goodloe Jeffrey M., Heniff Melanie, Homme James (Jim) L., Ishimine Paul T., John Susan D., Joseph Madeline M., Hiu-Fung Lam Samuel, Lawson Simone L., Lee Moon O., Li Joyce, Lin Sophia D., Martini Dyllon Ivy, Mellick Larry Bruce, Mendez Donna, Petrack Emory M., Rice Lauren, Rose Emily A., Ruttan Timothy, Saidinejad Mohsen, Santillanes Genevieve, Simpson Joelle N., Sivasankar Shyam M., Slubowski Daniel, Sorrentino Annalise, Stoner Michael J., Sulton Carmen D., Valente Jonathan H., Vora Samreen, Wall Jessica J., Wallin Dina, Walls Theresa A., Waseem Muhammad, Woolridge Dale P., Shahid Sam, Miller Roberta, Wood Elyssa, Lowery Tasha, Cohen Julie, VanStanton Rebecca, Hill Lisa, Stone Elizabeth, Johnson Domenique, , ,
Affiliation:
1. aDepartment of Clinical Emergency Medicine & Pediatrics, David Geffen School of Medicine at UCLA, Institute for Health Services and Outcomes Research, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, and Department of Emergency Medicine, Harbor UCLA Medical Center, Los Angeles, California 2. bDepartment of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island 3. cDepartment of Emergency Medicine, University of California San Francisco, UCSF Benioff Children’s Hospital, San Francisco, California 4. dDivision of Emergency Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Evanston, Illinois 5. eDivision of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, University of Florida Health Sciences Center, Jacksonville, Jacksonville, Florida 6. fAscension Seton Northwest Hospital, Austin, Texas 7. gEmergency Medicine and Trauma Center, Children’s National Hospital, Washington, District of Columbia 8. hDepartment of Emergency Medicine, Lincoln Medical Center, Bronx, New York 9. iIndependent Consultant, Pediatric Emergency and Trauma Nursing 10. jThe Medical Associates, Dallas, Texas 11. kDepartments of Medicine and Pediatrics, University of California, Los Angeles, Los Angeles, California 12. lDepartments of Pediatrics and Emergency Medicine, Emory University School of Medicine, CPG Sedation Services, Children’s Healthcare of Atlanta, Egleston, Atlanta, Georgia 13. mDivision of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Hasbro Children’s Hospital, Warren Alpert Medical School of Medicine at Brown University, Providence, Rhode Island 14. nDivision of Emergency Medicine, Boston Children’s Hospital, Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts
Abstract
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure; challenges with timely access to a mental health professional; the nature of a busy ED environment; and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affect patient care and ED operations. Strategies to improve care for MBH emergencies, including systems-level coordination of care, are therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
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