No family wants to be debating whether they should take their child to the emergency room (ER) for a mental health crisis. But many children and teens experience challenges with mental health, and families may not know what to do or where to get the right care.
Jamie Becker, PhD, ABPP, Pediatric Psychologist at Children's Health℠ , about shares when to seek emergency care for a mental health concern, what is considered a mental health emergency or crisis and what other resources are available.
"If you're not sure, go to the ER because we never want you to go without help," Dr. Becker says. "But it's also important to know that the ER is not the only place that can help in a mental health crisis."
What is a mental health crisis?
The National Alliance for Mental Illness (NAMI) defines a mental health crisis as any situation where a person's behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community. Common mental health crises we see at the Children's Health Emergency Room include:
- Suicidal ideation, which means thinking about or planning suicide
- Eating disorders where a child will not eat or drink
- Anxiety events, such has having a panic attack and experiencing symptoms like chest pains, trouble breathing and heart racing
- Psychotic events, where a child is hallucinating and may be seeing or hearing things that other people are not
- Aggression, where a child is threatening to harm themselves or others
When should I take my child to the ER for mental health?
The ER is the right place for a child experiencing a mental health crisis that requires medical attention to treat physical symptoms. For example:
- If you know or think your child has overdosed on medication
- If your child has an injury like a gash or broken bone as a result of aggression, impulsiveness, self-harm or any other reason
- If your child is fainting or nonresponsive as a result of an eating disorder or any other reason
"The ER is the place to go when kids need medical attention first and foremost," Dr. Becker says. "If they've taken too much medication, definitely bring them here. But if what you're really looking for is access to mental health services, there are likely other avenues that are going to be more efficient than the emergency room."
I'm not sure if the ER is the right place for my child's mental health emergency. Are there other options?
There may be other options, depending on your child's needs and where you live. Other options include:
- Pediatric mental and behavioral health facilities. These facilities solely serve kids and teens experiencing mental and behavioral health problems. Many of these programs offer emergency services for youth experiencing mental health crises. These programs may be able to connect children with the resources they need faster than the ER.
- Pediatric inpatient facilities. These are specifically for children ages 17 and younger who cannot be kept safe at home and need round-the-clock care because of severe mental illness.
What happens at the ER during a mental health emergency?
When you go to the ER for a mental health emergency, the first step is a triage assessment, also called a medical screening exam. This screening determines whether a child requires any necessary medical treatment. From there, the medical team in the ER will decide to involve a mental health provider to assist in the evaluation.
At Children's Health, a licensed mental health professional called an ED clinical therapist will conduct this assessment and meet with the caregiver and child individually. From there, they will make recommendations to the medical team about the best next steps. The process may be different at other hospitals.
What are the next steps after a mental health emergency room visit?
After a mental health emergency room visit at Children's Health, families can typically expect one of three next steps:
- Going home with recommendations for follow-up care. This might include different levels of mental health care ranging from a few appointments with a counselor to intensive programs for several hours per week. Families are provided a list of resources prior to leaving the ER, but Children's Health Psychiatry will also follow up within one week after your visit to see if you were able to connect with the recommended resources or need more help. This is the most common next step.
- Inpatient psychiatry transfer. Some children and teens who come to the ER will require inpatient psychiatric care. This means that they require treatment in a facility focused on the stabilization of the mental health crisis. Children's Health has an inpatient unit focused on eating disorders, but does not have an inpatient psychiatry facility able to treat and stabilize other mental health conditions. If your child needs this level of care, we will transfer your child directly from the ER for safety.
- Medical intake. Rarely, if your child has a serious medical issue and is also experiencing a mental health crisis, they may need to be admitted to the hospital for medical care prior to the assessment and treatment of their mental health condition.
After their visit, children may be referred to programs and services at Children's Health and within our network, including:
- Suicide prevention (SPARC)
- Teen Recovery Program
- The Center for Pediatric Eating Disorders
- Haven Wellness Center
- Perimeter Behavioral Hospital of Dallas, for kids and teens who need inpatient care
What should I do if I'm worried about my child's mental health?
Your pediatrician is a great person to answer mental health questions and connect you with resources to get your child the support they need.
Children's Health offers many mental health resources for families, including many types of therapy both in-person and through telehealth.
Many children in Texas can also get access to free virtual mental health care through Children's Health℠ School-Based TeleBehavioral Health. This program can help children and teens navigate and overcome mental health challenges. To find out if your child's school participates in this program, ask your school counselor or call 844-856-6926.
"Schools and pediatricians are the frontline," Dr. Becker says. "They can help spot a potential mental health issue, answer questions and connect you to treatment that can help prevent a crisis or emergency."
Learn more
Children's Health psychologists and psychiatrists can help children and teens manage feelings of loneliness, depression and anxiety. Learn more about programs we offer to support mental, emotional and behavioral health.
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