Caring for adolescents with mental health problems: Challenges in the emergency department

Stewart, Claire; Spicer, Maureen; Babl, Franz E

doi:10.1111/j.1440-1754.2006.00959.x

Cited by 37 publications

(32 citation statements)

References 17 publications

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“…In our study, the most common presenting symptoms were suicidal ideation/thought (21.0%) and homicide/violence toward others (20.7%), which emphasized the need for emergency staff to have an informed approach to these problems, as reported by Santiago et al (20) (24). Of the youth from a mental health hospital pediatric emergency service, 62.5% were presented following an episode of deliberate self-harm and 11.5% with other behavioural difficulties (25).…”

Section: Discussionmentioning

confidence: 50%

“…While the percentages of the most common diagnoses in many studies were 28.1% (24) and 44% (29) for depression 24.6% (30) and, in first visit, 69% (31) for mood disorders, those in our study were 16.7% for conduct disorder (most frequent among boys) and 15.5% for conversion disorder (most frequent among girls). Also, Cuypers et al (21) found mood disorders (27.6%) and adjustment disorders (19.5%) as the most frequent axis I disorders in pediatric psychiatric patients consulting the PES of a large university hospital in Belgium between 2003 and 2008.…”

Section: Discussionmentioning

confidence: 57%

“…Moreover, in our study, approximately two-third of patients diagnosed with psychotic disorders and half of those with mood disorders were admitted, while Newton et al (7) reported admission rates of slightly less than half for psychotic-related illnesses and one-fourth for mood disorders at first visit in a large database. On the other hand, slightly more than half of the patients (54.0%) received medication, while the rates of medication administration were 29.1% and 47.1% in other studies (10,24). A relative lower rate of admission to the inpatient unit and a higher rate of medication administration may be attributable to mild symptoms of patients which have been thought to be treated satisfactorily with a drug and to the study setting that indications of hospitalization can be more rigorous.…”

Section: Discussionmentioning

confidence: 86%

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Characteristics of Pediatric Psychiatric Emergency Population in a Mental Health Hospital

Mutlu¹,

Kılıçoğlu²,

Güneş³

et al. 2015

EAJEM

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Aim: We aimed to investigate the characteristics of children and adolescents presented to the psychiatric emergency service (PES) of a mental health hospital. Materials and Methods:Medical records of patients under 18 years of age were reviewed for the first psychiatric emergency visit during a 1-year period. Results:The mean age was 15.82 years and 65.8% (n=711) were female. The most presenting symptoms were suicidal ideation (21.0%; most for girls) and homicide/violence toward others (20.7%; most for boys). The mean duration of symptoms was 265.36 days. The most common diagnoses were conduct disorder (16.7%; most for boys) and conversion disorder (15.5%; most for girls). Of the patients, 51.7% never used any mental health services before. The rate of prior use of mental health service was significantly higher in patients presenting with homicide/violence toward others and self-harm and lower in patients presenting with anxiety and somatic symptoms (p<0.05). Of the patients, 292 (27.0%) took no treatment and 271 (25.1%) were admitted to the psychiatric inpatient unit.Conclusion: PES can be used by half of the families as a first-line therapy unit. PES seems to serve an important role in the continuum of pediatric mental health care, particularly for youths with homicide/violence toward others, and to be a point of access to mental healthcare, particularly for youths with anxiety and somatic symptoms. (Eurasian J Emerg Med 2015; 14: 123-30)

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 86%

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Characteristics of Pediatric Psychiatric Emergency Population in a Mental Health Hospital

Mutlu¹,

Kılıçoğlu²,

Güneş³

et al. 2015

EAJEM

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“…Emergency units with 24/7 evaluation and admission facilities are important services to stabilize adolescents in mental health crisis [1,2]. Admitted, the patients often need extensive mental health resources [3].…”

Section: Introductionmentioning

confidence: 99%

Issues in Child and Adolescent Inpatient Assessment and Evaluation After Discharge: Protocol for App Development and a Randomized Controlled Trial (Preprint)

Hansson¹,

Johansson²,

Andersson³

et al. 2018

Preprint

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Background: New methods for in-and outpatient data collection and for improvning outpatient compliance after discharge are called for. Interactive and mobile technologies i.e. smartphone applications (apps) have shown promising results, e.g. helping unwell people by offering support and resources. Screening the current condition, including comorbidity, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed leading to inaccurate diagnosis and treatment. Also in child and adolescent psychiatric emergency settings, little is known regarding treatment satisfaction. One way of improving diagnostic accuracy and to increase knowledge regarding treatment satisfaction is to use a structured diagnostic process as well as adding a tool to assess consumer satisfaction. Digitalized screening and follow-up has the advantage of making the administration and scoring easier and less time consuming leading to higher response rate. To address the described problems we decided to create a smartphone application: Blå Appen. Objective: The aim of this paper is to describe the development of Blå Appen and to describe the two planned research studies to evaluate the application. Methods: Blå Appen was developed through 7 different steps: (1) Identifying the need for quick and easy information gathering; (2) identifying desired information and choosing adequate screening questionnaires (3) examining the feasibility in acute psychiatric environment -pilot study; (4) getting organizational acceptancefeasibility study; (5) App construction; (6) Workshop with adolescents -what do the patients think; (7) evaluation -research study 1 & 2. Results: (1) We decided to create a smartphone application based on our previous work on interactive voice response. (2) Eleven validated screening questionnaires were chosen with regard to frequent comorbid states in child & adolescent psychiatry. (3) A pilot study was performed (n=16) indicating good acceptability. In the next step (4) we performed a feasibility study concluding that the method we planned adds value for our patients and no existing solutions were found on the market. The IT department gave their final approval for funding in May 2015. (5) The work resulted in a public procurement. (6) We performed a workshop indicating good feasibility. (7) Two studies will be performed, one in inpatients identifying comorbid conditions and the other to assess outpatient compliance and treatment outcome. Conclusions: A technically advanced and easy-to-use web based mobile phone application corresponding to the unit's needs was developed and two studies to evaluate its usefulness were planned.

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“…Creating a safe physical space for behavioral health patients protects both staff members and patients. Maintaining specially designed areas decreases risk of harm and prevents nurses from finding themselves in danger [10] . Designing and constructing psychiatric emergency facilities requires dramatic financial investment, planning, and the dedication of leaders to support the needs of mental health communities.…”

Section: Constructing Safe Work Areasmentioning

confidence: 99%

When mental health and medicine collide: Maintaining safety in the emergency department

Vierheller

Denton

2013

JNEP

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Mental health patients seeking care through emergency departments (ED) create different challenges for nurses than their medical counterparts. Understanding the special needs of psychiatric populations requires nurses to identify recurring characteristics, subgroups, and demographics. Psychiatric patients share similar traits that hinder their access to health care despite the distribution of mental illness across age, race, gender, and ethnic barriers. Similarities among psychiatric patients include impaired thought processes, tendency to withdraw from social interaction, and shame related to the stigma of mental illness. Psychiatric patients using emergency departments for primary care compound their vulnerable status by circumventing patient-provider relationships that develop when establishing routine practice and familiarity with a primary care physician. This article illustrates how nurses in the American health care system, specifically those in emergency specialties, can respond to environmental challenges while caring for mental health patients. Strategic planning allows ED teams to prepare for an influx of mental health patients and maintain safety as they serve this vulnerable population.

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Caring for adolescents with mental health problems: Challenges in the emergency department

Cited by 37 publications

References 17 publications

Characteristics of Pediatric Psychiatric Emergency Population in a Mental Health Hospital

Characteristics of Pediatric Psychiatric Emergency Population in a Mental Health Hospital

Issues in Child and Adolescent Inpatient Assessment and Evaluation After Discharge: Protocol for App Development and a Randomized Controlled Trial (Preprint)

When mental health and medicine collide: Maintaining safety in the emergency department

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