The number of children and adolescents seen in emergency departments (EDs) and primary care settings for mental health problems has skyrocketed in recent years, with up to 23% of patients in both settings having diagnosable mental health conditions.1–4 Even when a mental health problem is not the focus of an ED or primary care visit, mental health conditions, both known and occult, may challenge the treating clinician and complicate the patient’s care.4Although the American Academy of Pediatrics (AAP) has published a policy statement on mental health competencies and a Mental Health Toolkit for pediatric primary care providers, no such guidelines or resources exist for clinicians who care for pediatric mental health emergencies.5,6 Many ED and primary care physicians report paucity of training and lack of confidence in caring for pediatric psychiatry patients. The 2 clinical reports support the 2006 joint policy statement of the AAP and the American College of Emergency Physicians on pediatric mental health emergencies,7 with the goal of addressing the knowledge gaps in this area. Although written primarily from the perspective of ED clinicians, it is intended for all clinicians who care for children and adolescents with acute mental health and behavioral problems. They are organized around the common clinical challenges pediatric caregivers face, both when a child or adolescent presents with a psychiatric chief complaint or emergency (part I) and when a mental health condition may be an unclear or complicating factor in a non–mental health ED presentation (part II). Part I of the clinical reports includes discussions of Medical Clearance of Pediatric Psychiatric Patients, Suicide and Suicidal Ideation, Restraint of the Agitated Patient Including Verbal, Chemical, and Physical Restraint, and Coordination of Care With the Medical Home, and it can be accessed online at www.pediatrics.org/cgi/doi/10.1542/peds.2016-1570. This executive summary is an overview of part II of the clinical reports. Full text of the following topics can be accessed online at www.pediatrics.org/cgi/doi/10.1542/peds.2016-1573 .Key considerations include the following:Thomas H. Chun, MD, MPH, FAAPSharon E. Mace, MD, FAAP, FACEPEmily R. Katz, MD, FAAPJoan E. Shook, MD, MBA, FAAP, ChairpersonJames M. Callahan, MD, FAAPThomas H. Chun, MD, MPH, FAAPGregory P. Conners, MD, MPH, MBA, FAAPEdward E. Conway Jr, MD, MS, FAAPNanette C. Dudley, MD, FAAPToni K. Gross, MD, MPH, FAAPNatalie E. Lane, MD, FAAPCharles G. Macias, MD, MPH, FAAPNathan L. Timm, MD, FAAPKim Bullock, MD – American Academy of Family PhysiciansElizabeth Edgerton, MD, MPH, FAAP – Maternal and Child Health BureauBrian R. Moore, MD, FAAP – National Association of EMS PhysiciansTamar Magarik Haro – AAP Department of Federal AffairsMadeline Joseph, MD, FACEP, FAAP – American College of Emergency Physicians Angela Mickalide, PhD, MCHES – EMSC National Resource CenterKatherine E. Remick, MD, FAAP – National Association of Emergency Medical TechniciansSally K. Snow, RN, BSN, CPEN, FAEN – Emergency Nurses AssociationDavid W. Tuggle, MD, FAAP – American College of SurgeonsCynthia Wright-Johnson, MSN, RNC – National Association of State EMS OfficialsAlice D. Ackerman, MD, MBA, FAAP Lee Benjamin, MD, FACEP, FAAP - American College of PhysiciansSusan M. Fuchs, MD, FAAP Marc H. Gorelick, MD, MSCE, FAAP Paul Sirbaugh, DO, MBA, FAAP - National Association of Emergency Medical TechniciansJoseph L. Wright, MD, MPH, FAAPSue TellezLee S. Benjamin, MD, FACEP, ChairpersonIsabel A. Barata, MD, FACEP, FAAPKiyetta Alade, MDJoseph Arms, MDJahn T. Avarello, MD, FACEPSteven Baldwin, MDKathleen Brown, MD, FACEPRichard M. Cantor, MD, FACEPAriel Cohen, MDAnn Marie Dietrich, MD, FACEPPaul J. Eakin, MDMarianne Gausche-Hill, MD, FACEP, FAAPMichael Gerardi, MD, FACEP, FAAPCharles J. Graham, MD, FACEPDoug K. Holtzman, MD, FACEPJeffrey Hom, MD, FACEPPaul Ishimine, MD, FACEPHasmig Jinivizian, MDMadeline Joseph, MD, FACEPSanjay Mehta, MD, MEd, FACEPAderonke Ojo, MD, MBBSAudrey Z. Paul, MD, PhDDenis R. Pauze, MD, FACEPNadia M. Pearson, DOBrett Rosen, MDW. Scott Russell, MD, FACEPMohsen Saidinejad, MDHarold A. Sloas, DOGerald R. Schwartz, MD, FACEPOrel Swenson, MDJonathan H. Valente, MD, FACEPMuhammad Waseem, MD, MSPaula J. Whiteman, MD, FACEPDale Woolridge, MD, PhD, FACEPCarrie DeMoor, MDJames M. Dy, MDSean Fox, MDRobert J. Hoffman, MD, FACEPMark Hostetler, MD, FACEPDavid Markenson, MD, MBA, FACEPAnnalise Sorrentino, MD, FACEPMichael Witt, MD, MPH, FACEPDan SullivanStephanie Wauson
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