Abstract
Adolescent suicide is on the rise and treatment resources are scarce. Adolescents with suicidal behavior often are evaluated in the Emergency Department (ED), where the default treatment recommendation traditionally has been admission to an inpatient psychiatric unit. Emergency Medicine increasingly provides intervention in the ED with the goal of stabilization and discharge, avoiding unnecessary inpatient stays that are expensive and utilize limited resources. Family-Based Crisis Intervention (FBCI) is a manualized psychiatric intervention that is used to optimize care for suicidal adolescents and their families in the ED. This paper presents the framework of FBCI and includes a case to demonstrate the essential parts of the treatment.
Similar content being viewed by others
References
Aguilera, D. C., & Messick, J. M. (1990). Crisis intervention: Theory and methodology. St. Louis, MO: Mosby.
American College of Emergency Physicians. (ACEP). (2008). ACEP Psychiatric and substance abuse survey 2008 Retrieved June 2, 2008, from http://www.acep.org/uploadedFiles/ACEP/Advocacy/federal_issues/PsychiatricBoardingSummary.pdf.
Asarnow, J. R., Baraff, L., Berk, M., Grob, C., Devich-Navarro, M., Suddath, R., et al. (2011). An emergency department intervention for linking pediatric suicidal patients to follow-up mental health treatment. Psychiatric Services, 62(11), 1303–1309.
Bernstein, S. L., Aronsky, D., Duseja, R., Epstein, S., Handel, D., Hwang, U., et al. (2009). The effect of emergency department crowding on clinically oriented outcomes. Academic Emergency Medicine, 16(1), 1–10.
Brooker, C., Ricketts, T., Bennett, S., & Lemme, F. (2007). Admission decisions following contact with an emergency mental health assessment and intervention service. Journal of Clinical Nursing, 16(7), 1313–1322. doi:10.1111/j.1365-2702.2007.01302.x.
Bruffaerts, R., Sabbe, M., & Demyttenaere, K. (2008). Emergency psychiatry in the 21st century: Critical issues for the future. European Journal of Emergency Medicine, 15(5), 276–278.
Burns, D. (1999). The feeling good handbook. New York, NY: Penguin Group.
Camilli, V., & Martin, J. (2005). Emergency department nurses’ attitudes toward suspected intoxicated and psychiatric patients. Topics in Emergency Medicine, 27, 313–331.
Center for Disease Control. (2007). Web-based Injury Statistics Query and Reporting System (WISQARS™). Atlanta, GA: US Department of Health and Human Services.
Center for Disease Control. (2008). Suicide trends among youths and young adults aged 10–24 years—United States, 1990—2004. Morbidity and Mortality Weekly Report (MMWR), 56(35), 905–908.
Center for Disease Control and Prevention. (1998). Youth risk behavior surveillance-United States, 1997. Morbidity and Mortality Weekly Report (MMWR), 43(6), 1–18.
Center for Disease Control and Prevention. (2007). Youth risk behavior surveillance—United States, 2007. Morbidity and Mortality Weekly Report (MMWR), 57, SS-4.
Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42(4), 386–405.
Greenfield, B., Larson, C., Hechtman, L., Rousseau, C., & Platt, R. (2002). A rapid-response outpatient model for reducing hospitalization rates among suicidal adolescents. Psychiatric Services, 53(12), 1574–1579.
Hellzen, O., & Lilja, L. (2008). Former patient’s experiences of psychiatric care: A qualitative investigation. International Journal of Mental Health Nursing, 17(4), 279–286.
Henggeler, S. W., Rowland, M. D., Halliday-Boykins, C., Sheidow, A. J., Ward, D. M., Randall, J., et al. (2003). One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis. Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 543–551.
Henggeler, S. W., Rowland, M. D., Randall, J., Ward, D. M., Pickrel, S. G., Cunningham, P. B., et al. (1999). Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: Clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 38(11), 1331–1339.
Hoot, N. R., & Aronsky, D. (2008). Systematic review of emergency department crowding: Causes, effects, and solutions. Annals of Emergency Medicine, 52(2), 126–136. doi:10.1016/j.annemergmed.2008.03.014.
Hoot, N. R., Epstein, S. K., Allen, T. L., Jones, S. S., Baumlin, K. M., Chawla, N., et al. (2009a). Forecasting emergency department crowding: an external, multicenter evaluation. Ann Emerg Med, 54(4), 514–522 e519. doi: 10.1016/j.annemergmed.2009.06.006.
Hoot, N. R., Leblanc, L. J., Jones, I., Levin, S. R., Zhou, C., Gadd, C. S., et al. (2009b). Forecasting emergency department crowding: A prospective, real-time evaluation. Journal of the American Medical Informatics Association, 16(3), 338–345. doi:10.1197/jamia.M2772.
Huey, S. J, Jr, Henggeler, S. W., Rowland, M. D., Halliday-Boykins, C. A., Cunningham, P. B., Pickrel, S. G., et al. (2004). Multisystemic therapy effects on attempted suicide by youths presenting psychiatric emergencies. Journal of the American Academy of Child and Adolescent Psychiatry, 43(2), 183–190.
Iyer, S., Reeves, S., Varadarajan, K., & Alessandrini, E. (2011). The acute care model: A new framework for quality care in emergency medicine. Clinical Pediatric Emergency Medicine, 12(2), 91–101. doi:10.1016/j.cpem.2011.04.002.
Klein, J. B., Jacobs, R. H., & Reinecke, M. A. (2007). Cognitive-behavioral therapy for adolescent depression: A meta-analytic investigation of changes in effect-size estimates. Journal of the American Academy of Child and Adolescent Psychiatry, 46(11), 1403–1413. doi:10.1097/chi.0b013e3180592aaa.
Lewis, L. M. (2007). No-harm contracts: A review of what we know. Suicide and Life-Threatening Behavior, 37(1), 50–57.
Mansbach, J. M., Wharff, E., Austin, S. B., Ginnis, K., & Woods, E. R. (2003). Which psychiatric patients board on the medical service? Pediatrics, 111(6 Pt 1), e693–e698.
McCarthy, M. L., Zeger, S. L., Ding, R., Aronsky, D., Hoot, N. R., & Kelen, G. D. (2008). The challenge of predicting demand for emergency department services. Academic Emergency Medicine, 15(4), 337–346. doi:10.1111/j.1553-2712.2008.00083.x.
McIntosh, J. L. (2010). USA suicide 2007: Official final data. Washington, DC: American Association of Suicidology.
Nicks, B. A., & Manthey, D. M. (2012). The impact of psychiatric patient boarding in emergency departments. Emergency Medicine International, 2012, 360308. doi:10.1155/2012/360308.
Office of Disease Prevention and Health Promotion. (2000). Healthy people 2010. Rockville, MD: US Department of Health and Human Services.
Parad, H. J. (1965). Preventive casework: Problems and implications. In H. J. Parad (Ed.), Crisis intervention: Selected readings. New York, NY: Family Service Association of America.
Rabin, E., Kocher, K., McClelland, M., Pines, J., Hwang, U., Rathlev, N., et al. (2012). Solutions to emergency department ‘boarding’and crowding are underused and may need to be legislated. Health Affairs, 31(8), 1757–1766.
Rotheram-Borus, M. J., Piacentini, J., Cantwell, C., Belin, T. R., & Song, J. (2000). The 18-month impact of an emergency room intervention for adolescent female suicide attempters. Journal of Consulting and Clinical Psychology, 68(6), 1081–1093.
Rotheram-Borus, M. J., Piacentini, J., Van Rossem, R., Graae, F., Cantwell, C., Castro-Blanco, D., et al. (1996). Enhancing treatment adherence with a specialized emergency room program for adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 35(5), 654–663.
Spirito, A., Esposito-Smythers, C., Wolff, J., & Uhl, K. (2011). Cognitive-behavioral therapy for adolescent depression and suicidality. Child & Adolescent Psychiatric Clinics of North America, 20(2), 191–204. doi:10.1016/j.chc.2011.01.012.
Staggs, L., Peek, M., Southard, G., Gracely, E., Baxendale, S., Cross, K. P., et al. (2012). Evaluating the length of stay and value of time in a pediatric emergency department with two models by comparing two different albuterol delivery systems. Journal of Medical Economics, 15(4), 704–711.
Stewart, C., Spicer, M., & Babl, F. E. (2006). Caring for adolescents with mental health problems: Challenges in the emergency department. Journal of Paediatrics and Child Health, 42(11), 726–730.
The Joint Commission. (2009). National Patient Safety Goals Hospital Program.
Wharff, E., Ginnis, K., & Ross, A. (2012). Family-based crisis intervention with suicidal adolescents in the emergency room: A pilot study. Social Work, 57(2), 133–143.
Wharff, E. A., Ginnis, K. B., Ross, A. M., & Blood, E. A. (2011). Predictors of psychiatric boarding in the pediatric emergency department: Implications for emergency care. Pediatric Emergency Care, 27(6), 483–489. doi:10.1097/PEC.0b013e31821d8571.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ginnis, K.B., White, E.M., Ross, A.M. et al. Family-Based Crisis Intervention in the Emergency Department: A New Model of Care. J Child Fam Stud 24, 172–179 (2015). https://doi.org/10.1007/s10826-013-9823-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-013-9823-1