The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies
Authors: Saidinejad Mohsen , Duffy Susan , Wallin Dina , Hoffmann Jennifer A. , Joseph Madeline M. , Uhlenbrock Jennifer Schieferle , Brown Kathleen , Waseem Muhammad , Snow Sally , Andrew Madeline , Kuo Alice A. , Sulton Carmen , Chun Thomas , Lee Lois K. ,   AMERICAN ACADEMY OF PEDIATRICS Committee on Pediatric Emergency Medicine, Conners Gregory P. , Callahan James , Gross Toni , Joseph Madeline M. , Lee Lois K. , Mack Elizabeth , Marin Jennifer , Mazor Suzan , Paul Ronald , Timm Nathan , Cicero Mark , Dietrich Ann , Eisenberg Andrew , Fallat Mary , Tellez Sue ,   AMERICAN COLLEGE OF EMERGENCY PHYSICIANS Pediatric Emergency Medicine Committee, Dietrich Ann M. , Alade Kiyetta H. , Amato Christopher S. , Atanelov Zaza , Auerbach Marc , Barata Isabel A. , Benjamin Lee S. , Berg Kathleen T. , Chang Cindy , Chow Jessica , Chumpitazi Corrie E. , Claudius Ilene A. , Easter Joshua , Foster Ashley , Fox Sean M. , Gausche-Hill Marianne , Gerardi Michael J. , Goodloe Jeffrey M. , Heniff Melanie , Homme James (Jim) L. , Ishimine Paul T. , John Susan D. , Joseph Madeline M. , Hiu-Fung Lam Samuel , Lawson Simone L. , Lee Moon O. , Li Joyce , Lin Sophia D. , Martini Dyllon Ivy , Mellick Larry Bruce , Mendez Donna , Petrack Emory M. , Rice Lauren , Rose Emily A. , Ruttan Timothy , Saidinejad Mohsen , Santillanes Genevieve , Simpson Joelle N. , Sivasankar Shyam M. , Slubowski Daniel , Sorrentino Annalise , Stoner Michael J. , Sulton Carmen D. , Valente Jonathan H. , Vora Samreen , Wall Jessica J. , Wallin Dina , Walls Theresa A. , Waseem Muhammad , Woolridge Dale P. , Shahid Sam ,   EMERGENCY NURSES ASSOCIATION Pediatric Committee, Miller Roberta , Wood Elyssa , Lowery Tasha , Cohen Julie , VanStanton Rebecca , Hill Lisa , Stone Elizabeth , Johnson Domenique 
Published: August 2023

Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure; challenges with timely access to a mental health professional; the nature of a busy ED environment; and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affect patient care and ED operations. Strategies to improve care for MBH emergencies, including systems-level coordination of care, are therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.