Overview
Mental illness in adolescents significantly increases the risk of medical emergencies, hospitalizations, and readmissions 1. Unaccompanied refugee minors (URM) in Europe, a population often under 18, experience a high prevalence of mental health disorders 2.Diagnosis
Management
Integrated medical-psychiatric care models in pediatric emergency settings may reduce hospital admissions and readmissions for adolescents with acute mental disorders 1.
Emergency triage innovations, including multidisciplinary staffing and training for psychiatric assessment, have been shown to reduce admissions 1.
Telepsychiatry consultations can decrease emergency hospital admissions 1.
Psychological therapies delivered in emergency departments, such as psychoeducation and risk-reduction counseling for suicide prevention, can reduce admissions 1.
Telephone follow-up may also contribute to reduced admissions 1.Special Populations
Unaccompanied refugee minors (URM) in Europe, particularly those from Afghanistan, have a high prevalence of mental health disorders, including PTSD, depression, anxiety, and behavioral problems 2.
URM exhibit higher rates of suicide attempts and deaths compared to the host population 2.
Risk factors for mental health issues in URM include social support levels in the host country and rearing environment 2.
Adolescents aged 8-25 years were included in a review of integrated care models for medical emergencies related to mental illness 1.Key Recommendations
Implement integrated medical-psychiatric care models within pediatric emergency settings to improve outcomes for adolescents experiencing medical emergencies related to mental illness 1. (Evidence: Moderate)
Utilize emergency triage innovations, such as multidisciplinary staffing and psychiatric assessment training, to reduce hospital admissions 1. (Evidence: Moderate)
Employ telepsychiatry consultations as a strategy to decrease emergency hospital admissions 1. (Evidence: Moderate)
Integrate psychological therapies, including psychoeducation and suicide prevention counseling, into emergency department care to reduce admissions 1. (Evidence: Moderate)
Provide telephone follow-up as an intervention to potentially lower hospital admission rates 1. (Evidence: Moderate)References
1 Otis M, Barber S, Amet M, Nicholls D. Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review. European child & adolescent psychiatry 2023. link
2 Daniel-Calveras A, Baldaquí N, Baeza I. Mental health of unaccompanied refugee minors in Europe: A systematic review. Child abuse & neglect 2022. link