When and how to send kids to the emergency room

“The first thing I would say to any clinician is that it’s never wrong to send a child to the emergency room,” said Amy Dryer, MD, pediatrician and REACH faculty member.

Having spent 10 years in a hospital emergency department, Dr. Dryer is intimately familiar with the criteria ER physicians use to decide to admit psychiatric patients: a medical condition, suicidal ideation with a lethal plan, homicidal ideation, or active psychosis.

However, she emphasized that your decision to refer to the ER doesn’t hinge on whether the patient is likely to be admitted. “If what they’re telling you makes you uncomfortable,” she said, “go ahead and refer them.”

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Suicide crisis among Black youth

As suicidality among adolescents generally has declined in the past three decades, suicide attempts among Black adolescents have risen, according to a November 2019 article in Pediatrics. A report to the Congressional Black Caucus (CBC) says that rates of suicide death have risen more for Black youth than for any other racial or ethnic group. A growing concern is that Black youth are less likely to report suicidal thoughts but more likely to attempt suicide; Black males are more likely to suffer injury or death as a result. Suicidality is also increasing among younger children. The reasons for these changes are not clear. However, the risk factors for suicidality and underlying mental health conditions among Black children and youth are myriad.

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