- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- Section 9 Child and Adolescent Psychiatry
- 9.1 General issues
- 9.2 Clinical syndromes
- 9.3 Situations affecting child mental health
- 9.4 The child as witness
- 9.5 Treatment methods for children and adolescents
- 9.5.1 Counselling and psychotherapy for children
- 9.5.2 Psychodynamic child psychotherapy
- 9.5.3 Cognitive behaviour therapies for children and families
- 9.5.4 Caregiver-mediated interventions for children and families
- 9.5.5 Medication for children and adolescents: current issues
- 9.5.6 Residential care for social reasons
- 9.5.7 Organization of services for children and adolescents with mental health problems
- 9.5.8 The management of child and adolescent psychiatric emergencies
- 9.5.9 The child psychiatrist as consultant to schools and colleges
- Section 10 Intellectual Disability (Mental Retardation)
- Section 11 Forensic Psychiatry
The management of child and adolescent psychiatric emergencies
- Chapter:
- The management of child and adolescent psychiatric emergencies
- Author(s):
Gillian C. Forrest
- DOI:
- 10.1093/med/9780199696758.003.0239
This chapter provides a practical approach to the management of psychiatric emergencies in children and adolescents. Such emergencies are challenging for a number of reasons. The professional resources available are usually very limited, and there is often confusion or even disagreement between professionals over what constitutes a psychiatric, as opposed to a social emergency. The parents or carers play a key role in the situation and need to be engaged and involved appropriately in the assessment and management; and issues of confidentiality and consent need to be taken into account. In addition, the psychiatrist may find himself or herself working in a variety of settings—the child's home, a hospital emergency department (A and E), a police station, a children's home, or residential school—where the facilities for assessing an angry, disturbed, or upset child may be far from ideal. Most emergencies occurring in community settings involve externalizing behaviours: aggression, violence; deliberate self-harm, or threats of harm to self or others; or extreme emotional outbursts. Some will involve bizarre behaviour which could be an indication of serious mental illness or intoxication by drugs or alcohol, or a combination of both. The emergency situation often arises in the context of acute family conflict or distress. Frequently other agencies are involved before the psychiatrist is called in (for example, emergency room staff, social workers, or the police). The on-call psychiatrist needs to be familiar with or able to obtain immediate advice about his or her local child and adolescent psychiatric services, the local child protection and child care procedures, and with the relevant mental health and child care legislation. Vignette 1:
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- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- Section 9 Child and Adolescent Psychiatry
- 9.1 General issues
- 9.2 Clinical syndromes
- 9.3 Situations affecting child mental health
- 9.4 The child as witness
- 9.5 Treatment methods for children and adolescents
- 9.5.1 Counselling and psychotherapy for children
- 9.5.2 Psychodynamic child psychotherapy
- 9.5.3 Cognitive behaviour therapies for children and families
- 9.5.4 Caregiver-mediated interventions for children and families
- 9.5.5 Medication for children and adolescents: current issues
- 9.5.6 Residential care for social reasons
- 9.5.7 Organization of services for children and adolescents with mental health problems
- 9.5.8 The management of child and adolescent psychiatric emergencies
- 9.5.9 The child psychiatrist as consultant to schools and colleges
- Section 10 Intellectual Disability (Mental Retardation)
- Section 11 Forensic Psychiatry