David Margulies, MD and Gabrielle Carlson, MD Describe Method for Comprehensive Psychiatric Evaluation of Pediatric Emergencies

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.