Children and young people with mental health issues admitted to the hospital: a toolkit for the general paediatrician

Abstract

As the number of children and young people (CYP) attending the emergency department (ED) with a mental health crisis is increasing, it has become evident that neither the environment nor the training for general paediatricians is adequate to meet CYPs’ mental health needs. This short article provides an essential toolkit for paediatricians and other healthcare professionals working with CYP. It provides a resource encompassing skills and knowledge to promote understanding of mental health crises and strategies to address these when CYP are in ED or admitted to the ward. It will allow general paediatricians to address the agitation and distress experienced by many CYP in EDs or on paediatric wards and use verbal de-scalation techniques rather than medications. The toolkit highlights how to take an appropriate mental health history, perform a mental state examination and if necessary medical investigations required, as well as providing an overview of the legal framework under which mental health conditions are managed in different age groups. A short section highlights the most common mental health issues and their management. Lastly, the CAMHS structure is explained to support the multi-professional collaboration needed to ensure CYP are managed appropriately between teams and have the best support and care possible in the ED and on paediatric wards.