Discussion On Treatment Of Psychiatric Emergencies In Childr

Discussion Treatment Of Psychiatric Emergencies In Children Versus Ad

Discussing the treatment of psychiatric emergencies requires understanding the differences in managing such crises across various age groups, particularly between children, adolescents, and adults. Each group presents unique clinical considerations, legal and ethical issues, and treatment modalities. This paper explores these differences through a hypothetical case scenario, emphasizing tailored interventions and ethical considerations.

Paper For Above instruction

To illustrate the differences in treating psychiatric emergencies in children versus adults, consider a hypothetical case scenario involving a 13-year-old male experiencing acute suicidal ideation. The adolescent has a history of depression exacerbated by recent bullying at school, leading to him attempting to overdose on medication. In an adult, such a case might primarily focus on medical stabilization, psychiatric assessment, and initiation of therapy or medication management. The approach would involve ensuring physical safety, immediate crisis intervention, and long-term psychiatric planning as outlined in Sadock, Sadock, and Ruiz’s comprehensive psychiatric volume (2014).

When treating this case as a child or adolescent, the approach differs significantly from adult treatment due to developmental, legal, ethical, and familial considerations. First, the treatment environment must be child-appropriate, which means involving pediatric mental health specialists familiar with adolescent development. The intervention might include family therapy, school consultation, and coordination with child protective services if abuse or neglect is suspected, aligning with the guidelines in Thapar et al.'s child and adolescent psychiatry (2015).

Family involvement is crucial in pediatric emergencies. Unlike adults, children’s treatment plans are often predicated on family-based interventions, emphasizing safety, communication, and the developmental needs of the youth. In emergency settings, stabilization might involve short-term inpatient or day treatment programs with a focus on safety, emotional regulation, and psychoeducation. Pharmacological treatments, if necessary, are carefully considered, weighing risks and benefits, considering age-appropriate dosages, and potential side effects as discussed by Stahl (2014)

Legal and ethical issues become particularly salient when working with minors. Informed consent and assent are key; while parents or guardians typically provide consent for treatment, respecting the child's developing autonomy and ensuring they understand their treatment options is ethically imperative. Confidentiality is another complex issue, as information must be shared appropriately with guardians and school systems to ensure safety but also within the bounds of legal protections (American Psychiatric Association, 2013).

Mandated reporting laws necessitate that clinicians report suspected abuse or neglect, which is particularly relevant when such issues underpin some psychiatric emergencies involving minors. Ethical considerations also include ensuring that interventions are in the child's best interest, promoting minimal coercion, and preventing trauma associated with involuntary treatment. The clinician’s role includes balancing patient rights with safety concerns, with special attention to developmental differences that influence capacity for decision-making.

In conclusion, treating psychiatric emergencies in children and adolescents requires a nuanced approach that recognizes developmental stages, family dynamics, legal rights, and ethical principles. While stabilization and safety are primary goals across all age groups, tailored interventions involving families, developmentally appropriate communication, and careful legal considerations distinguish pediatric emergency psychiatric care from adult treatment.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
• Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
• Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
• Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
• American Academy of Child and Adolescent Psychiatry. (2019). Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 58(1), 57-75.
• Garland, A. F., et al. (2015). Family-focused approaches in psychiatric treatment of youth: Interventions and outcomes. Child and Adolescent Psychiatric Clinics, 24(2), 317-334.
• Fazel, S., et al. (2014). Mental healthcare provision in child and adolescent psychiatric emergencies. The Lancet Psychiatry, 1(3), 227-232.
• Simons, A. H. (2016). Ethics and legal issues in child and adolescent psychiatric emergencies. Child and Adolescent Mental Health, 21(2), 85-92.
• Levy, S. E., et al. (2018). Ethical principles and practice in pediatric psychiatric emergencies. Journal of Child and Family Studies, 27(4), 1112-1121.
• Nebhin, D., & Bowden, V. R. (2019). Involuntary hospitalization in juvenile psychiatry: Balancing safety and rights. International Journal of Law and Psychiatry, 62, 101-109.