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) 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.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Santillanes G, Foster AA, Ishimine P, et al. Management of youth with suicidal ideation: Challenges and best practices for emergency departments. J Am Coll Emerg Physicians Open. 2024;5(2):e13141. Published 2024 Apr 3. doi:10.1002/emp2.13141
ISSN
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
Journal of the American College of Emergency Physicians Open
Source
PMC
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Final published version
Full Text Available at
This item is under embargo {{howLong}}