The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies
Mohsen Saidinejad, Susan Duffy, Dina Wallin, Jennifer A. Hoffmann, Madeline Joseph, Jennifer Schieferle Uhlenbrock, Kathleen Brown, Muhammad Waseem, Sally K. Snow, Madeline Andrew, Alice A. Kuo, Carmen Sulton, Thomas H. Chun, Lois K. Lee, Gregory P. Conners, James Callahan, Toni Gross, Madeline Joseph, Lois K. Lee, Elizabeth A. Mack, Jennifer R. Marín, Suzan Mazor, Ronald I. Paul, Nathan Timm, Mark X. Cicero, Ann Dietrich, A.D. Eisenberg, Mary E. Fallat, Sue Tellez, Ann Dietrich, Kiyetta Alade, Christopher S. Amato, Zaza Atanelov, Marc Auerbach, Isabel A. Barata, Lee S. Benjamin, Kathleen T. Berg, Kathleen M. Brown, Cindy Chang, Jessica Chow, Corrie E. Chumpitazi, Ilene Claudius, Joshua Easter, Ashley A. Foster, Sean M. Fox, Marianne Gausche‐Hill, Michael Gerardi, Jeffrey M. Goodloe, Melanie Heniff, James L. Homme, Paul Ishimine, Susan D. John, Madeline Joseph, Samuel H. F. Lam, Simone L. Lawson, Moon O. Lee, Joyce Li, Sophia Lin, Dyllon Ivy Martini, Larry B. Mellick, Donna Mendez, Emory M. Petrack, Lauren Rice, Emily Rose, Timothy Ruttan, Mohsen Saidinejad, Genevieve Santillanes, Joelle N. Simpson, Shyam M. Sivasankar, Daniel Slubowski, Annalise Sorrentino, Michael J. Stoner, Carmen Sulton, Jonathan H. Valente, Samreen Vora, Jessica Wall, Dina Wallin, Theresa A. Walls, Muhammad Waseem, Dale Woolridge, Sam Shahid, Roberta R. Miller, Elyssa B. Wood, Tasha Lowery, Julie Cohen, Rebecca VanStanton, Lisa Hill, Elizabeth C. Stone, Domenique Johnson
Abstract
Mental and behavioral health (MBH) visits of children and youth to emergency departments are increasing in the United States. Reasons for these visits range from suicidal ideation, self-harm, and eating and substance use disorders to behavioral outbursts, aggression, and psychosis. Despite the increase in prevalence of these conditions, the capacity of the health care system to screen, diagnose, and manage these patients continues to decline. Several social determinants also contribute to great disparities in child and adolescent (youth) health, which affect MBH outcomes. In addition, resources and space for emergency physicians, physician assistants, nurse practitioners, and prehospital practitioners to manage these patients remain limited and inconsistent throughout the United States, as is financial compensation and payment for such services. This technical report discusses the role of physicians, physician assistants, and nurse practitioners, and provides guidance for the management of acute MBH emergencies in children and youth. Unintentional ingestions and substance use disorder are not within the scope of this report and are not specifically discussed.