Emergency Department Handbook : Children and Adolescents with Mental Health Problems

A practical handbook to everything a practitioner needs to know about dealing with children and young people who visit an emergency department with mental health problems. Provides accessible knowledge on child and adolescent mental health problems and what to do about them. Clinical examples and comprehensive, easy to follow guidance are given throughout. Will help all practitioners working in A&E to provide a better service to patients by improving their understanding and skills related to young people s mental health. Subjects covered include: confidentiality; understanding the family; developmental and legal contexts; 'being' therapeutic; carrying out balanced risk assessments; service organisation and resourcing. Readership All healthcare professionals working in emergency medicine. Plus, junior doctors in both psychiatry and paediatrics (who are often the first out-of-hours port-of-call). Table Of Contents 1. INTRODUCTION 2. CONTEXTS FOR THE ASSESSMENT OF CHILDREN AND ADOLESCENTS 3. EMERGENCY ASSESSMENT AND CRISIS INTERVENTION 4. CHILD AND ADOLESCENT MENTAL HEALTH PRESENTATIONS IN THE EMERGENCY DEPARTMENT 5. SELF-HARM: ISSUES, ASSESSMENT AND INTERVENTION 6. DEALING WITH VIOLENCE AND SERIOUS BEHAVIOURAL DISTURBANCE RESTRAINING CHILDREN AND YOUNG PEOPLE: GUIDELINES RAPID TRANQUILLISATION GUIDELINES 7. CONSENT, CAPACITY AND THE LAW 8. CHILD ABUSE AND CHILD PROTECTION 9. CULTURAL DIVERSITY AND MENTAL HEALTH PROBLEMS IN CHILDREN AND YOUNG PEOPLE 10. SPECIAL CONSIDERATIONS 11. CONFIDENTIALITY AND INFORMATION-SHARING 12. PRACTITIONERS AND PATHWAYS: A COMPETENCY FRAMEWORK 13. ISSUES FOR DEPARTMENT HEADS AND MANAGERS APPENDICES 1. This practical handbook covers everything a practitioner needs to know about dealing with children and adolescents who present in an emergency department with mental health problems. It provides an easily accessible framework of knowledge on child and adolescent mental health, with comprehensive, easy-to follow guidance. The book includes contributions from professionals across a range of disciplines: paediatrics, child and adolescent psychiatry, liaison psychiatry, emergency medicine, and social care. The authors clarify the roles and responsibilities of every professional involved in the care of young patients and their families in a very vulnerable and potentially frightening situation. The subjects covered include:Understanding child and adolescent mental health problems.Their social and developmental contexts.The management of common mental health problems in this age group.Carrying out balanced risk assessments.Liaison with social services and the role of other agencies.The legal context.Confidentiality and child protection.Diversity issues. ~ Highly Commended in the Psychiatry category of the 2010 BMA Medical Book Awards. ~ ReadershipThe book is intended for psychiatrists at all levels dealing with young people, paediatricians and emergency department clinicians, teachers and trainers, and the heads of department, managers and commissioners who work together to provide effective and efficient services to meet the needs of this under-served client group. Cover 1 CoverII 2 Contents 7 Acknowledgements 9 Contributors 10 Abbreviations 12 Tables, boxes and figures 13 Chapter 1: Introduction 15 Chapter 2: Contextual factors in assessing children and adolescents 24 Chapter 3: Emergency assessment and crisis intervention 33 Chapter 4: Child and adolescent mental health presentations in the emergency department 47 Chapter 5: Self-harm: issues, assessment and interventions 77 Chapter 6: Violence and extreme behaviour 90 Chapter 7: Consent, capacity and mental health legislation 100 Chapter 8: Child abuse and child protection 112 Chapter 9: Cultural diversity and mental health problems 121 Chapter 10: Special considerations 129 Chapter 11: Confidentiality and information sharing 135 Chapter 12: Practitioners and pathways: a competency framework 140 Chapter 13: Issues for department heads and managers 158 Appendix I: Recommendations of the JointColleges Working Group on CAMHS in the emergency department 176 Appendix II: Mental state examination checklist 183 Appendix III: Mental Health Act 2007:brief guide 186 Appendix IV: Ten essential shared competencies for mental health practice 189 Appendix V: Protocols 191 Appendix VI: Emergency department mental health risk assessment tool 199 Index 201 A practical handbook to everything a practitioner needs to know about dealing with children and young people who present, with their families, in an emergency department with mental health problems. It provides an accessible framework of knowledge on these problems and what to do about them. Clinical examples and clear guidance are given throughout Offers information that practitioners need to know about dealing with children and young people who present, with their families, in an emergency department with mental health problems. This book provides a framework of knowledge on child and adolescent mental health problems and what to do about them.