Emergency Psychiatric Care in Childhood and Adolescence

“I can’t believe I am not dead. I want to be dead, but those pills did not work as fast as I expected. Dad found me and called 911. I cannot go on living after what they said about me on the Internet. My life is ruined and I cannot go back to school or even show my face around here. They all think I am that way, but I am not. Dad thinks this was a mistake, but he is wrong. When I get out of here, I am going to try something different, and this time it will work.”
Jessica, age 13

When psychiatric emergencies arise, they can present many challenges to the PMHNP. While there are many approaches to emergencies that are similar, there are also significant differences when dealing with children and adolescents versus adults. This is particularly true with coordination of care, availability of resources, and legal implications of the psychiatric emergency.

This week, you examine psychiatric emergencies that arise during childhood and adolescence and compare how those emergencies are assessed and treated to those of adult clients.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 23, “Emergency Psychiatric Medicine” (pp. 785–790)
• Chapter 31, “Child Psychiatry” (pp. 1226–1253)
  

  Treatment of Psychiatric Emergencies in Children Versus Adults

  The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

  Learning Objectives

  Students will:

  • Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients
  • Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

  To Prepare:

  • Review the Learning Resources concerning emergency psychiatric medicine.
  • Consider a case where an adult client had a psychiatric emergency. If you have not had a personal experience with an adult client who had a psychiatric emergency, you can conduct an internet or library search to identify one.

  Post:

  • Briefly describe the case you selected.
  • Explain how you would treat the client differently if he or she were a child or adolescent.
  • Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

  References not older than 5years.