Department of Clinical Emergency Medicine & Pediatrics, David Geffen School of Medicine at UCLA, Institute for Health Services and Outcomes Research, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, and Department of Emergency Medicine, Harbor UCLA Medical Center, Los Angeles, California.
Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island.
Pediatrics. 2023 Sep 1;152(3). doi: 10.1542/peds.2023-063255.
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.
儿童和青少年的心理和行为健康（MBH）紧急情况不仅继续越来越多地影响急诊科（ED），而且还影响儿童的整个紧急医疗服务范围，从院前服务到社区。照顾患有 MBH 疾病的儿童和青少年的社区和机构基础设施不足，使 ED 成为这些患者医疗保健安全网的重要组成部分。因此，越来越多的儿童和青少年因广泛的 MBH 紧急情况被转介到 ED 进行评估，从抑郁症和自杀倾向到破坏性行为和攻击性行为。然而，为这些患者提供最佳护理的挑战包括人员、能力和基础设施不足；及时获得心理健康专业人员的机会有限；ED 环境繁忙的性质；以及 ED 后出院资源的匮乏。这些因素导致 ED 停留时间延长和住院，从而对患者护理和 ED 运营产生负面影响。因此，需要采取策略来改善 MBH 紧急情况的护理，包括护理的系统层面协调。本政策声明及其配套技术报告的目的是强调改善儿科 MBH 紧急护理提供的策略、资源和建议。
