268166 Family-Based Crisis Intervention for suicidal adolescents in the Emergency Department: Results of an open trial

Tuesday, October 30, 2012

Abigail Ross, MSW, MPH , School of Social Work, Boston University, Boston, MA
Katherine Ginnis, MSW, MPH , Emergency Psychiatry, Boston Children's Hospital, Boston, MA
Elizabeth Wharff, PhD , Harvard Medical School, Children's Hospital Boston; Emergency Psychiatry Service, Boston, MA
Background: Suicide is a significant public health problem. The emergency department (ED) often serves as a portal to the mental health system for the majority of suicidal adolescents. The prevailing model of care for psychiatric patients in the ED is evaluation and disposition, with little or no treatment provided at the time of the visit. Aims: This presentation describes results of an open trial of a family-based crisis intervention (FBCI) for suicidal adolescents and their families in a large, urban pediatric ED. FBCI is an intervention designed to sufficiently stabilize patients within a single ED visit so that they may return home safely with their families. Methods: Of the one hundred suicidal adolescents and their families in the pilot sample, sixty-seven patients met eligibility criteria for FBCI. Demographic and clinical characteristics and disposition outcomes from the pilot sample were compared to those obtained retrospectively from a matched comparison group (n=150). Statistical analyses compared group inpatient admission rates and disposition outcomes. Results: Patients in the pilot cohort were significantly less likely to be hospitalized than those in the comparison group (36% versus 55%, p<.001). Only two of the patients in the FBCI cohort were hospitalized immediately after receiving the intervention during their ED visit. Conclusions: FBCI with suicidal adolescents and their families during a single ED visit is feasible and safely limits the need for inpatient psychiatric hospitalization, thereby avoiding disruption of family, academic and social activities and increasing utilization of less intrusive and more cost-effective psychiatric treatment.

Learning Areas:
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1) Examine disposition patterns in a population of adolescents presenting to the Emergency Department with suicidality 2) Describe results of an open trial of a family-based crisis intervention (FBCI) for suicidal adolescents and their families in a large, urban pediatric ED 3) Identify implications for pediatric emergency psychiatric care

Keywords: Mental Health Care, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work in the Emergency Department at the hospital and am Co-Investigator of the ongoing randomized controlled trial.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.