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Child Mental Health

Improving Mental and Behavioral Health Among Young Patients

By Jonathan Springston, Editor, Relias Media

Three national organizations have issued a policy statement in which pediatric, emergency, and mental and behavioral health experts offered more than three dozen recommendations for managing pediatric patients in medical facilities and in their communities.

Children, adolescents, and young adults are presenting more often to emergency departments (EDs) seeking care for mental and behavioral health emergencies. A group of researchers in Florida reported suicide rates among 13- and 14-year-olds in the United States more than doubled between 2008 and 2018, although the CDC recently reported suicide rates declined 8% from 2021 to 2022 among all 10- to 24-year-olds.

Regardless, there is a problem, fueled by the rise of social media, COVID-19 pandemic-induced isolation, various resource shortages within the healthcare system, and other long-term systemic injustices.

“Emergency physicians continue to do all they can for these vulnerable patients, while limited community and specialty resources, staffing challenges, and systemic inequities accentuate systemic gaps in care,” said Christopher S. Kang, MD, FACEP, president of the American College of Emergency Physicians, one of the groups that worked on the policy recommendations. “These factors add to the challenges in already crowded emergency departments with limited bed space available. Compassionate, collaborative solutions are needed to improve local and national approaches to preventing and treating mental and behavioral emergencies.”

Outside the medical facility, the policy statement authors placed heavy emphasis on monitoring and prevention. For example, schools could screen and provide resources for staff to recognize mental and behavioral health issues. Where available, activate mobile mental health units to help in schools, physicians’ offices, and homes. Schools could develop telehealth emergency psychiatric medical controls to identify and divert low-acuity patients to facilities equipped to manage mental and behavioral health issues.

Inside EDs, all staff should be educated to recognize signs of mental and behavioral health issues, along with identifying patients who are at higher risk for struggling with such problems. This should be a part of a systematic method to assess patients and follow protocols in triage, safety assessment, monitoring, mental health, and medical evaluation. Also, the policy statement authors recommended staff advocate for pediatric-trained mental health professionals to be embedded into EDs.

“A dedicated multipronged, multidisciplinary approach will be necessary to provide patient-centered, trauma-informed services to improve the care of children and youth with MBH emergencies,” the statement authors concluded.

The cover story of the upcoming October issue of Hospital Case Management is about how case managers can help EDs handle the influx of patients at risk of suicide by finding mental health resources for them. The upcoming October issue of ED Management will include a package of articles about pediatric readiness in EDs, including the role of pediatric emergency care coordinators and the legal liabilities associated with improperly handling pediatric emergencies.

For more on this and related subjects, be sure to check out the latest issues of Emergency Medicine Reports and Pediatric Emergency Medicine Reports, along with the new Relias Media sourcebook, Soul Shock: The Mental Health Crisis in Healthcare Professionals.