Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

Chun, Thomas H.; Mace, Sharon E.; Katz, Emily

doi:10.1542/peds.2016-1570

Cited by 52 publications

(50 citation statements)

References 152 publications

(77 reference statements)

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“…The 35 included policy documents, ranged from: international guidance provided by the United Nations and WHO4 37–39; national suicide prevention strategies22 30 40–47; mental health strategies48–53 and frameworks54–58; to national practice guidelines detailing how CYP who are suicidal should be assessed and treated 19 29 59–62. The organisation and classification of these documents are illustrated in figure 2; providing language with which to describe the policy landscape.…”

Section: Resultsmentioning

confidence: 99%

“…Although it is not compulsory to follow guidelines, organisations and clinicians must be aware of them and potentially justify their decision making should they choose to not implement them. Included clinical guidelines were: the UK NICE Guidelines for Self-Harm in over 8s: short term management and prevention of recurrence,19 Self-Harm in over 8s long-term management and prevention of recurrence,61 the New Zealand document: The Assessment and Management of People at Risk of Suicide,60 the United States Preventative Task Force recommendations29 and the American Academy of Paediatrics Guidance 62. The Irish National Standard Operating Procedure for Child and Adolescent Mental Health Service (CAMHS)69 was also included in this category, because it was a national document and specifically addressed the treatment and care needs of suicidal CYP.…”

Section: Resultsmentioning

confidence: 99%

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Policy addressing suicidality in children and young people: an international scoping review

2019

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ObjectiveTo map key policy documents worldwide and establish how they address the treatment and care needs of children and young people (CYP) who are suicidal.DesignWe conducted a scoping review to systematically identify relevant key policy documents following a pre-established published protocol.Data sourcesFour databases (CINAHL; Medline; PsycINFO; The Cochrane Database of Systematic reviews) and the websites of key government, statutory and non-statutory agencies were searched. Google and Google Scholar were used to identify other policy documents and relevant grey literature. Leading experts were consulted by email.Eligibility criteria for selected studiesPolicies, policy guidance, strategies, codes of conduct, national service frameworks, national practice guidance, white and green papers, and reviews of policy—concerned with indicated suicide prevention approaches for children up to 18 years old. Limited by English language and published after 2000.Data extraction and synthesisData were extracted using a predetermined template. Second reviewers independently extracted 25%. Documents were categorised as international guidance, national policy and national guidance, and presented in a table providing a brief description of the policy, alongside how it specifically addresses suicidal CYP. Findings were further expressed using narrative synthesis.Results35 policy documents were included in the review. Although many recognise CYP as being a high-risk or priority population, most do not explicitly address suicidal CYP. In general, national guidance documents were found to convey that suicidal children should be assessed by a child and adolescent mental health practitioner but offer no clear recommendations beyond this.ConclusionThe lack of specific reference within policy documents to the treatment and care of needs of children who are suicidal highlights a potential gap in policy that could lead to the needs of suicidal children being overlooked, and varying interpretations of appropriate responses and service provision.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Policy addressing suicidality in children and young people: an international scoping review

2019

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“…Rather, it is the provider's role, with consultation, to decide whether or enlist designated emergency services, that is, law enforcement or mental health providers who are designated to determine the need for psychiatric care without consent. Specific protocols for evaluation and possible inpatient psychiatric admission vary from state to state, as do guidelines for confidentiality (Chun, Mace, & Katz, 2016). (See Table 3 for a list of state statutes regarding involuntary commitment.…”

Section: Suicide Assessmentmentioning

confidence: 99%

Suicide assessment and treatment in pediatric primary care settings

Sisler

Schapiro

Nakaishi

et al. 2020

Child Adoles Psych Nursing

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Topic This article will briefly review screening for depression and suicidal ideation in primary care and school‐based clinics, with a focus on in‐depth screening for imminent suicide risk, developing a safety plan, and incorporating handoffs to urgent and emergency mental health care personnel. The article will cover current definitions of levels of suicidal risk and clinic‐based protocols for a team approach to adolescents in crisis. Purpose To provide primary care and behavioral health nurses with evidence‐based suicide risk screening and assessment tools and best practices for using them in patient‐centered encounters with adolescents with suicidal thinking or behavior. Sources Used Journal articles, books, and reports. Conclusion Past studies have shown that many individuals who died by suicide had seen a primary care provider in 30 days before their deaths. Nurses in primary care settings should develop clinic‐based protocols for screening all adolescents for suicide risk, developing safety plans, and providing suicidal youth and families with monitoring, appropriate referrals, follow‐up, and support.

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“…Support for the use of de-escalation approaches in mental health settings is currently limited (Spencer & Johnson 2016), and even more so with children (Chun et al 2016). There might be benefits for the staff (e.g.…”

Section: De-escalation Approachmentioning

confidence: 99%

“…Children were not recognized as moral agents who can actively take part in decision-making processes. Adopting care approaches that are more attuned to children's moral experiences, based on an open discussion in contrast to a set of pre-established directives, could contribute to foster the development of a trusting relationship between children and staff that is often presented as key in helping manage a crisis (Caldwell et al 2014;Chun et al 2016).…”

Section: Comparison Child-adultmentioning

confidence: 99%

Children's moral experiences of crisis management in a child mental health setting

Montreuil

Thibeault

McHarg

et al. 2018

Int J Mental Health Nurs

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The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies.

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Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

Cited by 52 publications

References 152 publications

Policy addressing suicidality in children and young people: an international scoping review

Policy addressing suicidality in children and young people: an international scoping review

Suicide assessment and treatment in pediatric primary care settings

Children's moral experiences of crisis management in a child mental health setting

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