Adolescents in acute mental distress on inpatient pediatric settings: reflections from a pediatric liaison practitioner.
OBJECTIVE
The impact of adolescents in acute mental distress admitted onto inpatient pediatric settings: on the staff group caring for them and the adolescents' consequent experience of the service provided.


OBJECTIVE
To examine the impact that this client group can have on the staff, the environment, and wider professional system from an applied psychodynamic standpoint. The aim of this study is to identify practical strategies for providing effective child and adolescent mental health service consultation liaison for this complex and high-risk group.


METHODS
This study draws on psychoanalytic theories of adolescent development, trauma, organizational dynamics, and reflections on personal experiences in the field of pediatric liaison. The challenges of providing effective support in this context are illustrated with clinical examples from the author's own practice.


CONCLUSIONS
The importance of attending to the very primitive anxieties and subsequent defense mechanisms aroused in staff caring for adolescents in the context described is highlighted. A case is made for the provision of mental health consultation and support that provides emotional containment for the young people and staff, and that incorporates understanding of the organizational issues that can contribute to the complexity of this work.
Foster
Celeste
C
East Lancashire Child & Adolescent Mental Health Service, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Lancashire, UK. c.m.foster@salford.ac.uk
D000208:Acute Disease; D000223:Adaptation, Psychological; D000293:Adolescent; D041923:Adolescent Development; D000298:Adolescent, Hospitalized / Q000523:psychology*; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D003674:Defense Mechanisms; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D009720:Nurse Clinicians / Q000458:organization & administration / Q000523:psychology*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D010371:Pediatric Nursing / Q000379:methods; D011568:Psychiatric Nursing / Q000193:education / Q000379:methods*; D011574:Psychoanalytic Theory; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology; D014167:Transference, Psychology