The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies

Pediatric mental health crisis

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.

“The scope of this problem is really great,” said Dr. Mohsen Saidinejad, lead author and Pediatric Pandemic Network expert. “But our ability to solve it is not there.”

This policy statement aims to provide guidance on evidence-based best practices with resources and references to emergency physicians, PAs, and NPs for the management of MBH emergencies in children and youth.

Read the full policy statement from the American Academy of Pediatrics.