What To Do If Your Child Is Experiencing A Psychiatric Emergency

If your child is experiencing a psychiatric emergency (danger to self and/or others, experiencing delusions, hallucinations, disorganized thoughts and/or exhibiting unusual behaviors) take your child to your local hospital emergency room immediately. If your child is already under the care of a treatment provider, you may want to call the treatment provider first and ask for any special instructions that he/she would like you to follow. If you can not contact your child’s treatment provider immediately, then proceed to the hospital and try to contact him/her later. If your child is emotionally or physically out of control or has harmed him/herself or someone else, call 911 for assistance.

If Your Child Is Uncooperative In Going To The Hospital

Community resources that may be able to help you transport your child to the hospital:

Psychiatric Screening Center: All counties have a psychiatric screening center (see appendix A). The centers are located in designated county hospitals. Some centers serve more than one county. They are staffed by mental health professionals known as “screeners”. The role of the screener is to both protect an individual from self-harm in cases of a psychiatric emergency and to advocate for an individual’s right against involuntary hospitalization. Screeners intervene in situations when an individual appears to be experiencing a psychiatric emergency but is refusing medical assistance.

In cases when an individual appears to be having a psychiatric emergency, but is uncooperative in going to the hospital, many screening centers have a “mobile unit” that they deploy to the individual’s location. The mobile unit consists of 1-3 screeners accompanied by members of the local police department. Upon their arrival they evaluate the individual’s mental status. If they believe that a psychiatric emergency exists and that the individual is of danger to him/herself or others, then they exercise their legal authority to have the police bring the individual to the hospital against his/her will. Some screening centers (Morris, Passaic and Warren County) do not deploy their mobile unit in situations involving a minor (any person under the age of 18). If you live in such a county, you may need to get assistance from your local police department (read the Local Police Department section below).

In cases when an individual is already at the hospital and has been recommended for emergency inpatient admission, but refuses to comply, the screening center deploys a screener to the hospital in which the individual is being held. Upon arrival the screener conducts an independent mental health evaluation to determine and make the final decision on whether or not involuntary hospitalization is necessary. Most of the time the screener is in agreement with the hospital evaluation. However, on occasion the hospital is overruled and the individual is released.

Local Police Department: While all counties have a Psychiatric Screening Centers that you can contact in cases of a psychiatric emergency, some screening centers (Morris, Passaic and Warren County) do not deploy their mobile unit in situations involving a minor (any person under the age of 18). If your child is a minor and you live in such a county, you will need to contact your local police department for assistance. In psychiatric emergencies, police departments have the authority to assist parents in transporting a minor to the hospital. Police departments seem to vary in their level of sophistication in dealing with individuals (particularly minors) experiencing a psychiatric and/or substance abuse emergency. When involving your local police department,be prepared for all possible personalities, styles and protocols in how they intervene with your child. Regardless of their approach, remember that the important thing is that your child gets to the hospital where he/she can be further evaluated and treated.

What to do if your child refuses to go to the hospital:

If you attempt to take your child to the hospital and he/she is uncooperative, contact your county’s screening center for assistance. During your initial telephone contact with the screening center, be prepared to answer questions regarding your child’s current condition and related psychiatric history. Tell them the exact reason you believe your child needs to go to the hospital. Ask them to please intervene. If they inform you that they will be sending their mobile unit to assist, ask them how long it will take for them to arrive and for instructions on what to do until they get there. If for any reason the screening center is unable to deploy it’s mobile unit, then contact your local police department for assistance. If the screening center tells you they can’t intervene because in their clinical judgement your situation does not constitute a psychiatric emergency, ask them to advise you on how to access and utilize other community resources that can help.

What to do if you want your child admitted into the hospital for emergency hospitalization treatment:

If at the hospital you want your child admitted for emergency hospitalization treatment, communicate your request directly to the evaluating clinician. Tell him/her exactly what your child is doing that makes you believe emergency hospitalization treatment is necessary. Make sure you highlight behaviors that indicate your child may be a danger to him/herself or others. If it appears that the hospital is reluctant to admit your child, ask to fill out a request/application for hospitalization form. Doing so will document your concerns and thus force the hospital to give even greater consideration to your request. Be aware, however, that no matter how strongly and effectively you communicate your request, the hospital can choose not to admit your child for emergency hospitalization.

What to expect at the hospital:

Be prepared to provide the hospital with all pertinent insurance, demographic and medical information. If your child is already involved in some form of psychiatric treatment, remember to bring the treatment provider’s telephone number. The hospital might want to contact your child’s treatment provider and factor his/her clinical judgement into their evaluation. In preparation for going to the emergency room, remember to bring your child’s insurance card and any other information you think you might need to answer the intake questions.

Be prepared for a potentially very (very) long wait. Depending on how busy the hospital is, the recommendation of the evaluator and your child’s level of cooperation, your emergency room stay can be anywhere from two to twelve hours. If your child is recommended for inpatient psychiatric treatment, then he/she will be moved from the emergency room to another unit in the hospital or another hospital that has the appropriate type of psychiatric treatment available. In preparation for your potentially long day, it’s a good idea to bring some type of busy work (reading materials, crossword puzzles, letter writing, etc.) with you to pass the time. While your state of mind may not be conducive to busy work, emotionally it may be a good idea to force yourself.

Be prepared for a potentially stressful and emotionally draining experience. Depending on the quality of care you receive at the hospital, the length of time you’re there, the evaluation results, and your child’s emotional state and behavior throughout the process, you may experience an intense roller-coaster ride of fear, sadness, frustration, anger, rage, disappointment and guilt. In preparation for the potential roller coaster of emotion, it may be helpful to have a supportive family member or friend accompany you. Periodically focus on your breathing, step outside to take a walk, and assure yourself that you are strong and that you will endure and handle all possible outcomes.