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, 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) 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.