Mental Health Follow-up among Adolescent ED Patients

A study conducted in Ohio found that adolescents seen in an emergency department (ED) because of a suicidal crisis were more likely to return to the ED within two months (and to be subsequently hospitalized) if they had actually attempted suicide or had a history of inpatient psychiatric care. The authors suggested that this finding “highlights the importance of developing interventions that focus on high-risk suicidal adolescents, especially young people with prior inpatient admission, or those that have attempted suicide.” They recommended that such interventions include providing “a thorough structured interview and expanded suicide screening by personnel trained in suicide risk assessment to all patients presenting to the ED with mental health complaints.”

Two-thirds of the young people (ages 11-18 years) were seen by a mental health provider after their release. Follow-up was higher among patients with an existing psychiatric diagnosis. An absence of follow-up care put young people at increased risk for a return visit to the ED. Only one-third of those who made a return visit to the ED had successfully followed up with a mental health provider.

The authors recommended that ED staff should link young people with outpatient mental health services during, as well as after, their visit, and provide their parents with information, resources, and assistance during the critical period after their children have been released from the ED but before they receive follow-up mental health care.

The authors also noted that “almost a third of the patients who followed up did so through the partial hospitalization program” which they called “a valuable resource.” [Editorial note: Partial hospitalization programs provide intensive outpatient services for persons afflicted with serious mental or substance abuse disorders.]

Sobolewski, B., Richey, L., Kowatch, R.A., & Grupp-Phelan, J. (2013). Mental health follow-up among adolescents with suicidal behaviors after emergency department discharge. Archives of Suicide Research 17(4), 323–334.