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Camacho E, Masood FA. Pediatric Suicide: Supporting Nurses on the Front Lines. AACN Adv Crit Care 2024; 35:258-264. [PMID: 39213624 DOI: 10.4037/aacnacc2024854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Affiliation(s)
- Elena Camacho
- Elena Camacho is Suicide Prevention Specialist I, Behavioral Health Services, Nationwide Children's Hospital, 444 Butterfly Gardens Dr, Columbus, OH 43215
| | - Fatimah A Masood
- Fatimah A. Masood is Suicide Prevention Specialist II, Behavioral Health Services, Nationwide Children's Hospital, Columbus, Ohio
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Esposito J, Davis M, Boyd RC. Suicide Prevention in Pediatric Health Care Settings. Pediatr Clin North Am 2023; 70:1115-1124. [PMID: 37865434 DOI: 10.1016/j.pcl.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Given recent trends demonstrating increased suicide risk among youth, particularly those from minoritized populations, youth suicide is a major public health concern. Evidence-based practices for the identification and management of youth suicide risk have been developed, yet many challenges exist to implementing them routinely in health care settings. Suggestions for leveraging publicly available resources, gathering input from a range of stakeholders to inform implementation, and enhancing multidisciplinary collaboration are provided with the aim of offering tangible steps toward addressing the youth suicide crisis.
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Affiliation(s)
- Jeremy Esposito
- Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, USA
| | - Rhonda C Boyd
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Hannan C, Mayne SL, Kelly MK, Davis M, Young JF, Powell M, Stephens-Shields A, Dalembert G, McPeak KE, Jenssen BP, Fiks AG. Trends in Positive Depression and Suicide Risk Screens in Pediatric Primary Care During COVID-19. Acad Pediatr 2023; 23:1159-1165. [PMID: 36584938 PMCID: PMC9792424 DOI: 10.1016/j.acap.2022.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 12/08/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Adolescent mental health concerns increased during COVID-19, but it is unknown whether early increases in depression and suicide risk have been sustained. We examined changes in positive screens for depression and suicide risk in a large pediatric primary care network through May 2022. METHODS Using an observational repeated cross-sectional design, we examined changes in depression and suicide risk during the pandemic using electronic health record data from adolescents. Segmented logistic regression was used to estimate risk differences (RD) for positive depression and suicide risk screens during the early pandemic (June 2020-May 2021) and late pandemic (June 2021-May 2022) relative to before the pandemic (March 2018-February 2020). Models adjusted for seasonality and standard errors accounted for clustering by practice. RESULTS Among 222,668 visits for 115,627 adolescents (mean age 15.7, 50% female), the risk of positive depression and suicide risk screens increased during the early pandemic period relative to the prepandemic period (RD, 3.8%; 95% CI, 2.9, 4.8; RD, 2.8%; 95% CI, 1.7, 3.8). Risk of depression returned to baseline during the late pandemic period, while suicide risk remained slightly elevated (RD, 0.7%; 95% CI, -0.4, 1.7; RD, 1.8%; 95% CI, 0.9%, 2.7%). CONCLUSIONS During the early months of the pandemic, there was an increase in positive depression and suicide risk screens, which later returned to prepandemic levels for depression but not suicide risk. Results suggest that pediatricians should continue to prioritize screening adolescents for depressive symptoms and suicide risk and connect them to treatment.
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Affiliation(s)
- Chloe Hannan
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Stephanie L Mayne
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa.
| | - Mary Kate Kelly
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (JF Young), Philadelphia, Pa
| | - Maura Powell
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alisa Stephens-Shields
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania (A Stephens-Shields), Philadelphia, Pa
| | - George Dalembert
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Katie E McPeak
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Brian P Jenssen
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alexander G Fiks
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
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Maina C, Cioffi SPB, Altomare M, Spota A, Virdis F, Bini R, Ragozzino R, Renzi F, Reitano E, Corasaniti L, Macchini F, Chiara O, Cimbanassi S. Increasing Trend in Violence-Related Trauma and Suicide Attempts among Pediatric Trauma Patients: A 6-Year Analysis of Trauma Mechanisms and the Effects of the COVID-19 Pandemic. J Pers Med 2023; 13:jpm13010128. [PMID: 36675789 PMCID: PMC9864714 DOI: 10.3390/jpm13010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. During the COVID-19 pandemic (COVID-19), different trends for pediatric trauma (PT) were described. This study aims to explore the trend over time of PT in our center, also considering the effects of COVID-19, focusing on trauma mechanisms, violence-related trauma (VRT) and intentionality, especially suicide attempts (SAs). Methods: All PT patients accepted at Niguarda Trauma Center (NTC) in Milan from January 2015 to December 2020 were retrospectively analyzed. We considered demographics and clinical variables and performed descriptive and year comparison analyses. Results: There were 684 cases of PT accepted at NTC: 84 in 2015, 98 in 2016, 125 in 2017, 119 in 2018, 114 in 2019 and 144 in 2020 (p < 0.001), 66.2% male, mean age 9.88 (±5.17). We observed a higher number of traffic-related, fall-related injuries and an increasing trend for VRT and SAs, peaking in 2020. We report an increasing trend over time for head trauma (p = 0.002). The Injury Severity Score did not significantly change. During COVID-19 we recorded a higher number of self-presenting patients with low priority codes. Conclusions: NTC is the adult level I referral trauma center for the Milan urban area with pediatric commitment. During COVID-19, every traumatic emergency was centralized to NCT. In 2020, we observed an increasing trend in SAs and VRT among PT patients. The psychological impact of the COVID-19 restriction could explain this evidence. The long-term effects of COVID-19 on the mental health of the pediatric population should not be underestimated. Focused interventions on psychological support and prevention of SAs and VRT should be implemented, especially during socio-demographic storms such as the last pandemic.
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Affiliation(s)
- Cecilia Maina
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
- General Surgery, I.R.C.C.S. San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
| | - Stefano Piero Bernardo Cioffi
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
- Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-3386032519
| | - Michele Altomare
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
- Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Andrea Spota
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Francesco Virdis
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Roberto Bini
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Roberta Ragozzino
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Federica Renzi
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Elisa Reitano
- Division of General Surgery, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Eastern Piedmont, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
| | - Lucia Corasaniti
- Department of Pediatric Surgery, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Francesco Macchini
- Department of Pediatric Surgery, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Osvaldo Chiara
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Stefania Cimbanassi
- Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
- Department of Pathophysiology and Transplantation-State University of Milan-Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
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Fogaça VD, Souza DMD, Silva L, Guedes DMB, Domingues F, Trinquinato I, Rossato LM. Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study. Rev Bras Enferm 2023; 76:e20220137. [PMID: 37042925 PMCID: PMC10084778 DOI: 10.1590/0034-7167-2022-0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/18/2022] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt. METHODS an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis. RESULTS eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified. CONCLUSIONS adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
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Affiliation(s)
| | | | - Lucía Silva
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Theodorou CM, Yamashiro KJ, Stokes SC, Salcedo ES, Hirose S, Beres AL. Pediatric suicide by violent means: a cry for help and a call for action. Inj Epidemiol 2022; 9:13. [PMID: 35395936 PMCID: PMC8991570 DOI: 10.1186/s40621-022-00378-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/29/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Suicide is the second most common cause of death among adolescents and young adults. In the pediatric population, gunshot wounds (GSWs) and hangings are common mechanisms of pediatric suicide. Comorbid psychiatric illness is prevalent in this population, but psychiatric resource utilization after self-inflicted traumatic injury is not well characterized. METHODS We analyzed patients < 18 years old presenting to a level 1 pediatric trauma center after suicide attempt by GSW, hanging, or jumping from a height from 2009 to 2019. The primary outcome was psychiatric resource utilization. Secondary outcomes included prior emergency department (ED) visits to identify prior opportunities for intervention. RESULTS Of 6538 pediatric trauma patients, there were 219 GSWs, 7 hangings, and 7 jumps from height, for a total of 233 patients. Of these, 14 presented following a suicide attempt (four GSWs, six hangings, and four jumps, total 6.0%). Half of these patients died due to their injuries. Self-inflicted GSWs had the highest mortality (75%). Most surviving patients were placed on involuntary psychiatric holds (n = 5/7, 71.4%), and three patients were discharged to an inpatient psychiatric hospital (n = 3/7, 42.9%). Five of the 14 patients had prior ED visits (35.7%), and of these, 60% were for suicidal ideation or suicide attempts. CONCLUSIONS Among pediatric trauma patients, suicide attempts are rare, but are highly lethal, with the highest mortality rate seen in self-inflicted GSWs. Psychiatric resource utilization is high both during and after the hospitalization. Prior ED visits may represent opportunities for depression and suicidality screening in this at-risk population.
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Affiliation(s)
- Christina M. Theodorou
- Division of Pediatric General, Thoracic, and Fetal Surgery, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Room 5107, Sacramento, CA 95817 USA
| | - Kaeli J. Yamashiro
- Division of Pediatric General, Thoracic, and Fetal Surgery, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Room 5107, Sacramento, CA 95817 USA
| | - Sarah C. Stokes
- Division of Pediatric General, Thoracic, and Fetal Surgery, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Room 5107, Sacramento, CA 95817 USA
| | - Edgardo S. Salcedo
- Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Sacramento, CA USA
| | - Shinjiro Hirose
- Division of Pediatric General, Thoracic, and Fetal Surgery, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Room 5107, Sacramento, CA 95817 USA
| | - Alana L. Beres
- Division of Pediatric General, Thoracic, and Fetal Surgery, Department of Surgery, University of California Davis Medical Center, 2335 Stockton Blvd, Room 5107, Sacramento, CA 95817 USA
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Michaud PA, Michaud L, Mazur A, Hadjipanayis A, Kapp C, Ambresin AE. The Impact of COVID on Adolescent Mental Health, Self-Harm and Suicide: How Can Primary Care Provider Respond? A Position Paper of the European Academy of Pediatrics. Front Pediatr 2022; 10:800000. [PMID: 35402345 PMCID: PMC8984250 DOI: 10.3389/fped.2022.800000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Adolescents aged 10 to 19 live a period of their life marked by opportunities and vulnerabilities during which the issue of mental health is of prime importance. Since several decades, and especially since the start of the COVID pandemic, mental health problems and disorders among adolescents have increased around the world. Depression, self-harm and suicidal behavior are common during this period of life, and pediatricians can play a pivotal role in identifying affected or vulnerable youngsters. This article describes risk factors for self-harm and suicidal behavior and reviews how primary care pediatricians and health professionals can respond to such situations. This scoping review is based on existing evidences as well as the authors clinical experience. It suggests concrete actions that can be taken to secure the life of at risk teenagers, and discusses how to organize the transfer to mental health professionals when needed.
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Affiliation(s)
| | - Laurent Michaud
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Artur Mazur
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | | | - Carole Kapp
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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Bartek N, Peck JL, Garzon D, VanCleve S. Addressing the Clinical Impact of COVID-19 on Pediatric Mental Health. J Pediatr Health Care 2021; 35:377-386. [PMID: 34078570 PMCID: PMC7988467 DOI: 10.1016/j.pedhc.2021.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic impacts daily lives of families globally. Sequelae are not limited to physical consequences of medical complications but extend into social, emotional, spiritual, and psychological health. Interventions including mask-wearing and physical distancing are intended to prevent viral spread, but have unintended negative effects on mental health and child development. Although it is too early to know the full impact, practicing pediatric clinicians are well-positioned to help young people recover and thrive despite challenges presented. This article will review the impact of COVID-19 on child mental health and give practical interventions to foster resilience in youth and their families.
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Lusk P. Addressing the mental health needs of children/adolescents, families, and ourselves during our unprecedented COVID-19 times. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 33:185-186. [PMID: 33164251 DOI: 10.1111/jcap.12297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Pamela Lusk
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
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Sisler SM, Schapiro NA, Nakaishi M, Steinbuchel P. Suicide assessment and treatment in pediatric primary care settings. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 33:187-200. [PMID: 32573060 PMCID: PMC7666006 DOI: 10.1111/jcap.12282] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/28/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022]
Abstract
TOPIC This article will briefly review screening for depression and suicidal ideation in primary care and school-based clinics, with a focus on in-depth screening for imminent suicide risk, developing a safety plan, and incorporating handoffs to urgent and emergency mental health care personnel. The article will cover current definitions of levels of suicidal risk and clinic-based protocols for a team approach to adolescents in crisis. PURPOSE To provide primary care and behavioral health nurses with evidence-based suicide risk screening and assessment tools and best practices for using them in patient-centered encounters with adolescents with suicidal thinking or behavior. SOURCES USED Journal articles, books, and reports. CONCLUSION Past studies have shown that many individuals who died by suicide had seen a primary care provider in 30 days before their deaths. Nurses in primary care settings should develop clinic-based protocols for screening all adolescents for suicide risk, developing safety plans, and providing suicidal youth and families with monitoring, appropriate referrals, follow-up, and support.
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Affiliation(s)
- Shawna M. Sisler
- College of Nursing, Emma Eccles Jones Nursing Research CenterUniversity of UtahSalt Lake CityUtahUSA
| | - Naomi A. Schapiro
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Michelle Nakaishi
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Petra Steinbuchel
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
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