title: Child Psychiatric Emergencies: Updates on Trends, Clinical Care, and Practice Challenges.
abstract: Over the past 15 years, the number of pediatric patients presenting to the emergency room in psychiatric crisis has nearly doubled. Suicidality and aggression are among the most common presenting problems, making it important for providers to have up-to-date knowledge about the assessment and management of these frequently encountered clinical issues. Psychometrically sound suicide risk assessment tools are available for use in the emergency room setting, which can be administered efficiently with minimal provider training. Rates of off-label medication use in the pediatric population continue to increase and are often used in the management of acute agitation in the pediatric population. The current literature will be reviewed and summarized for application in emergent treatment settings. Overall, evidence to inform best practice is limited, leading to opportunities for innovation in health care delivery, the development of new research aims, and discussion of challenging clinical dilemmas.
authors.affiliation: Department of Psychiatry, University of Colorado, Aurora, CO, USA. Beau.carubia@childrenscolorado.org.|B. Harrison Levine, MD, Inc., Denver, CO, USA. Beau.carubia@childrenscolorado.org.
authors.forename: Beau
authors.initials: B
authors.lastname: Carubia
authors.affiliation: Department of Psychiatry, University of Colorado, Aurora, CO, USA.|Psychiatric Emergency Service, Children's Hospital Colorado, Aurora, CO, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Becker
authors.affiliation: B. Harrison Levine, MD, Inc., Denver, CO, USA.
authors.forename: B Harrison
authors.initials: BH
authors.lastname: Levine
mesh_terms: D000374:Aggression; D002648:Child; D003695:Delivery of Health Care / Q000639:trends; D004630:Emergencies; D004638:Emergency Treatment; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D011595:Psychomotor Agitation / Q000628:therapy
keywords: Agitation; Chemical restraint; Pediatric; Psychiatric emergency; Suicide