Management of youth with suicidal ideation: Challenges and best practices for emergency departments
Abstract Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI)...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13141 |
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| author | Genevieve Santillanes Ashley A. Foster Paul Ishimine Kathleen Berg Tabitha Cheng Ann Deitrich Melanie Heniff Gwen Hooley Christian Pulcini Timothy Ruttan Annalise Sorrentino Muhammad Waseem Mohsen Saidinejad |
| author_facet | Genevieve Santillanes Ashley A. Foster Paul Ishimine Kathleen Berg Tabitha Cheng Ann Deitrich Melanie Heniff Gwen Hooley Christian Pulcini Timothy Ruttan Annalise Sorrentino Muhammad Waseem Mohsen Saidinejad |
| author_sort | Genevieve Santillanes |
| collection | DOAJ |
| description | Abstract Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI) and self‐harm challenge many EDs in the United States. This review highlights currently identified best practices that all EDs can implement in suicide screening, assessment of youth with self‐harm and SI, care for patients awaiting inpatient psychiatric care, and discharge planning for youth determined not to require inpatient treatment. We will also highlight several controversies and challenges in implementation of these best practices in the ED. An enhanced continuum of care model recommended for youth with mental and behavioral health crises utilizes crisis lines, mobile crisis units, crisis receiving and stabilization units, and also maximizes interventions in home‐ and community‐based settings. However, while local systems work to enhance continuum capacity, EDs remain a critical part of crisis care. Currently, EDs face barriers to providing optimal treatment for youth in crisis due to inadequate resources including the ability to obtain emergent mental health consultations via on‐site professionals, telepsychiatry, and ED transfer agreements. To reduce ED utilization and better facilitate safe dispositions from EDs, the expansion of community‐ and home‐based services, pediatric‐receiving crisis stabilization units, inpatient psychiatric services, among other innovative solutions, is necessary. |
| format | Article |
| id | doaj-art-7befccf8126441ddab88353b5b56c00c |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-7befccf8126441ddab88353b5b56c00c2025-08-20T03:06:41ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522024-04-0152n/an/a10.1002/emp2.13141Management of youth with suicidal ideation: Challenges and best practices for emergency departmentsGenevieve Santillanes0Ashley A. Foster1Paul Ishimine2Kathleen Berg3Tabitha Cheng4Ann Deitrich5Melanie Heniff6Gwen Hooley7Christian Pulcini8Timothy Ruttan9Annalise Sorrentino10Muhammad Waseem11Mohsen Saidinejad12Department of Emergency Medicine, Keck School of Medicine of USCLos Angeles General Medical CenterLos Angeles California USADepartment of Emergency Medicine University of California San Francisco California USADepartments of Emergency Medicine and PediatricsUniversity of California, San Diego School of Medicine, UC San Diego Health and Rady Children's HospitalSan Diego California USADepartment of Pediatrics, Dell Medical SchoolThe University of TexasAustin Texas USADepartment of Emergency Medicine Harbor UCLA Medical Center David Geffen School of Medicine at UCLA Los Angeles California USADivision Chief Pediatric Emergency Medicine Department of Emergency Medicine Prisma Health University of South Carolina School of Medicine Greenville South Carolina USADepartments of Emergency Medicine and PediatricsIndiana University School of MedicineIndianapolis Indiana USADivision of Emergency and Transport Medicine Children's Hospital Los Angeles Los Angeles California USADepartment of Emergency Medicine and Pediatrics University of Vermont Larner College of Medicine Burlington Vermont USADepartment of Pediatrics Dell Medical School The University of Texas at Austin. US Acute Care Solutions Canton Ohio USADepartment of Pediatrics, Division of Emergency MedicineUniversity of AlabamaBirmingham Alabama USALincoln Medical Center, Bronx New York; Weill Cornell Medicine New York USADepartments of Emergency Medicine and PediatricsDavid Geffen School of Medicine at UCLALos Angeles California USAAbstract Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI) and self‐harm challenge many EDs in the United States. This review highlights currently identified best practices that all EDs can implement in suicide screening, assessment of youth with self‐harm and SI, care for patients awaiting inpatient psychiatric care, and discharge planning for youth determined not to require inpatient treatment. We will also highlight several controversies and challenges in implementation of these best practices in the ED. An enhanced continuum of care model recommended for youth with mental and behavioral health crises utilizes crisis lines, mobile crisis units, crisis receiving and stabilization units, and also maximizes interventions in home‐ and community‐based settings. However, while local systems work to enhance continuum capacity, EDs remain a critical part of crisis care. Currently, EDs face barriers to providing optimal treatment for youth in crisis due to inadequate resources including the ability to obtain emergent mental health consultations via on‐site professionals, telepsychiatry, and ED transfer agreements. To reduce ED utilization and better facilitate safe dispositions from EDs, the expansion of community‐ and home‐based services, pediatric‐receiving crisis stabilization units, inpatient psychiatric services, among other innovative solutions, is necessary.https://doi.org/10.1002/emp2.13141mental and behavioral healthpediatric emergencypsychiatric emergencysuicide |
| spellingShingle | Genevieve Santillanes Ashley A. Foster Paul Ishimine Kathleen Berg Tabitha Cheng Ann Deitrich Melanie Heniff Gwen Hooley Christian Pulcini Timothy Ruttan Annalise Sorrentino Muhammad Waseem Mohsen Saidinejad Management of youth with suicidal ideation: Challenges and best practices for emergency departments Journal of the American College of Emergency Physicians Open mental and behavioral health pediatric emergency psychiatric emergency suicide |
| title | Management of youth with suicidal ideation: Challenges and best practices for emergency departments |
| title_full | Management of youth with suicidal ideation: Challenges and best practices for emergency departments |
| title_fullStr | Management of youth with suicidal ideation: Challenges and best practices for emergency departments |
| title_full_unstemmed | Management of youth with suicidal ideation: Challenges and best practices for emergency departments |
| title_short | Management of youth with suicidal ideation: Challenges and best practices for emergency departments |
| title_sort | management of youth with suicidal ideation challenges and best practices for emergency departments |
| topic | mental and behavioral health pediatric emergency psychiatric emergency suicide |
| url | https://doi.org/10.1002/emp2.13141 |
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