An article on the Assessment of Child and Adolescent Psychiatric
Emergencies by David Margulies, MD and Gabrielle Carlson, MD was
published in the February 2012 edition of Child and Adolescent Psychopharmacology News.
The article was written as a response to a recommendation by the
National Center for Children in Poverty that emergency department staff
receive additional training in screening, treating and referring young
people who present with mental health or substance use disorders or with
medical problems which may be psychiatrically related.
Drs.
Margulies and Carlson organize their article around a mnemonic they use
to train residents and fellows in the Comprehensive Psychiatric
Emergency Room: STAB, which stands for Suicidality, Terrible
psychosocial situation, Aggression, and Bizarre behavior.
The
authors discuss the salient features of each of these four factors in
terms of assessment, diagnosis and intervention. Although they recommend
a number of rating scales and guidelines as aids, they highlight the
need for a methodical and complete clinical evaluation of the patient,
including an assessment of the family and school environments, and a
careful assessment of risk.
They conclude that since emergency
departments will continue to be important providers of psychiatric
evaluation of children and youth, they should strive to make their
assessments as comprehensive as possible by using the STAB approach.
