II. Epidemiology

  1. Adult and child psychiatry patient presentations to the emergency department are increasing
    1. Larkin (2005) Psychiatr Serv 56(6): 671-7 [PubMed]
    2. Sills (2002) Pediatrics 110(4): e40 [PubMed]
  2. Inadequate number of psychiatry beds and psychiatric consultants available (especially pediatric)
    1. Baraff (2006) Ann Emerg Med 48(4): 452-8 [PubMed]

IV. Evaluation: Safety

  1. See Suicide Risk
  2. Parental Consent is not required for Emergency Psychiatric Evaluation of a minor
    1. Primary goal is maintaining a safe environment for the child
    2. Physical Restraints and Sedation in Excited Delirium may be required (and do not require consent)

VII. Disposition

  1. See Clinical Sobriety
  2. Children with expressed Suicidality or homicidality
    1. Does child understand what they did and their intent (e.g. attention-seaking)?
    2. Does the child have underlying condition making them unaware of their actions (e.g. Autism)?
    3. Do parents have insight into child's behavior and believe they can provide a safe environment?

VIII. References

  1. Zun, Swaminathan and Egan in Herbert (2014) EM:Rap 14(7): 11-13
  2. Claudius, Behar and Bendaoud in Herbert (2015) EM:Rap 15(12):5

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