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Helping Emergency Rooms Prepare for Kids in Crisis

Associate Administrators Dr. Michael Warren (MCHB) and Tom Morris (FORHP) discussed in a recent webcast HRSA's release of a toolkit for clinicians confronted with young patients in mental distress.
Associate Administrators Dr. Michael Warren (MCHB) and Tom Morris (FORHP) discussed in a recent webcast HRSA's release of a toolkit for clinicians confronted with young patients in mental distress. National Suicide Prevention Week was earlier this month -- with teen suicides a growing problem.

 

At a time when increasing numbers of children are showing up in emergency rooms with mental health issues, less than half of the nation's hospitals have written protocols in place for care coordination and management of kids in crisis – and that number falls to about a third in rural areas, two senior HRSA leaders reported in a recent webcast.

Suicide is now the second leading cause of death among young people, age 10 to 19 years old. And absent immediate intervention, the risk of a suicide attempt or death by self-harm is highest within 30 days of discharge from an emergency department.

Those findings are the impetus behind a new HRSA guide to help emergency room staff manage young people in psychiatric distress, said Associate Administrators Dr. Michael Warren and Tom Morris.

"Emergency (rooms) are seeing an increasing number of children and adolescents in mental health crises," said Dr. Warren. "However, the emergency medical services system is often not adequately prepared to manage these patients."

 

Teen Suicide Statistics Chart showing the following: The suicide rate for kids ages 10-14 has doubled over the last 10 years. 28.3% of students reported that they felt so sad or hopeless almost every day in a two week period that they stopped doing some usual activities. In a 12 month period prior to a CDC survey, 19% of students had seriously considered attempting suicide. Source: U.S. Centers for Disease Control and Prevention (CDC)

 

The new HRSA guide incorporates case studies from rural emergency staffs across the U.S. One urgent care facility had no inpatient beds and is 100 miles away from the closest receiving hospital – a familiar profile for the nation's small rural providers. Staff reported seeing about 700 patients per month, 40 percent of whom were minors. Of these pediatric patients, about 5 percent were experiencing mental health issues.

"The staff spoke about the many pediatric patients that are foster children whose guardians cannot provide the needed transport due to their living situations," staff reported.

In all, 10 federal agencies contributed to the new HRSA toolkit, dubbed Critical Crossroads (PDF - 1.8 MB).

"Children are … often discharged from the (emergency department) without guided referrals for mental health-specific follow-up care," the toolkit concludes. "Connecting children and adolescents to all available mental health resources poses a challenge in rural settings where services are often limited."

One in 5 kids experience a mental disorder at some point during their lifetime.

Learn more about the new toolkit.

Date Last Reviewed:  September 2019