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Helping Kids in Crisis

Managing Psychiatric Emergencies in Children and Adolescents

Edited by Fadi Haddad, M.D., and Ruth Gerson, M.D.

  • ISBN 978-1-58562-482-9
  • Item #62482
First Prize in Psychiatry at the 2015 British Medical Association Medical Book Awards

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Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents provides expert guidance to practitioners responding to high-stakes situations, such as children considering or attempting suicide, cutting or injuring themselves purposely, and becoming aggressive or violently destructive. Children experiencing behavioral crises frequently reach critical states in venues that were not designed to respond to or support them—in school, for example, or at home among their highly stressed and confused families. Professionals who provide services to these children must be able to quickly determine threats to safety and initiate interventions to deescalate behaviors, often with limited resources. The editors and authors have extensive experience at one of the busiest and best regional referral centers for children with psychiatric emergencies, and have deftly translated their expertise into this symptom-based guide to help non-psychiatric clinicians more effectively and compassionately care for this challenging population.

The book is designed for ease of use and its structure and features are helpful and supportive:

  • The book is written for practitioners in hospital or community-based settings, including physicians in training, pediatricians who work in office-based or emergency settings, psychologists, social workers, school psychologists, guidance counselors, and school nurses—professionals for whom child psychiatric resources are few.
  • Clear risk and diagnostic assessment tools allow clinicians working in settings without access to child mental health professionals to think like trained emergency room child psychiatrists—from evaluation to treatment.
  • The content is symptom-focused, enabling readers to swiftly identify the appropriate chapter, with decision trees and easy-to-read tables to use for quick de-escalation and risk assessment.
  • A guide to navigating the educational system, child welfare system, and other systems of care helps clinicians to identify and overcome systems-level barriers to obtain necessary treatment for their patients.
  • Finally, the book provides an extensive review of successful models of emergency psychiatric care from across the country to assist clinicians and hospital administrators in program design.

An abundance of case examples of common emergency symptoms or behaviors provides professionals with critical, concrete tools for diagnostic evaluation, risk assessment, decision making, de-escalation, and safety planning. Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents is a vital resource for clinicians facing high-risk challenges on the front lines to help them intervene effectively, relieve suffering, and keep their young patients safe.


  • Contributors
  • Introduction
  • Acknowledgments
  • Chapter 1. Kids in Crisis
  • Chapter 2. Aggression
  • Chapter 3. Suicide and Self-Injurious Behaviors
  • Chapter 4. Tantrums and Behavioral Outbursts
  • Chapter 5. The Odd Child
  • Chapter 6. Child Abuse and Trauma
  • Chapter 7. Risky Behaviors
  • Chapter 8. Clinical and Forensic Psychological Issues With At-Risk Youths and Juvenile Delinquents
  • Chapter 11. Models of Emergency Psychiatric Care for Children and Adolescents: MOVING FROM TRIAGE TO MEANINGFUL ENGAGEMENT IN MENTAL HEALTH TREATMENT
  • Index


    Maggie Bielsky, LMSW
    Gabrielle S. Carson, Ph.D.
    Ruth Gerson, M.D.
    Charles J. Glawe, M.D.
    Fadi Haddad, M.D.
    Jennifer F. Havens, M.D.
    Alessandra D. E. Herbosch, Psy.D.
    Rachel Mandel, M.D.
    Mollie C. Marr, B.F.A.
    Jasmine Marrero, LCSW
    Melissa Negron, LCSW
    Stephen Ross, M.D.
    Susan B. Torrey, M.D.
    M. Cevdet Tosyali, M.D.
    J. Rebecca Weis, M.D.

About the Authors

Fadi Haddad, M.D., is Director Emeritus of Bellevue Hospital Children's Comprehensive Psychiatric Emergency Program, and Clinical Assistant Professor in the Department of Child and Adolescent Psychiatry at New York University School of Medicine in New York, New York.

Ruth S. Gerson, M.D., is the Director of Bellevue Hospital Children's Comprehensive Psychiatric Emergency Program, and Clinical Assistant Professor in Department of Child and Adolescent Psychiatry at New York University School of Medicine in New York, New York.

Drs. Haddad and Gerson, and their collaborating authors, have written an excellent, comprehensive and instructive guide on to how to think about, approach, assess, and care for these patients and their families. How to care for common clinical presentations, e.g. depressed and/or suicidal child or adolescent, the agitated/violent patient, to the not so common, e.g. patients in the juvenile justice or law enforcement system and the odd child, are covered in a clear and practical manner. Each chapter begins with an illustrative case presentation, and closes with succinct, easy to follow flow diagram, summarizing the chapter's conceptual and clinical information. Additionally, the too familiar problems patients and non-mental health clinicians experience accessing the mental health care system are addressed in the two chapters on how to find (mental healthcare) help and models for Emergency Psychiatry, both within and outside of the ED setting.—Thomas Chun, M.D., MPH, Associate Professor of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University

Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents is a must-read guide for parents, teachers, guidance counselors, school administrators, youth program directors and anyone else who works with children and adolescents on a day to day basis. The wisdom of the authors, all of whom have experience working in psychiatric emergency systems, is much needed advice as more children are sent to emergency departments across the country for behavioral emergencies and threats. Chapters on common crisis situations seen in children and adolescents, such as tantrums, suicidal threats or behavior, aggression, and the management of the odd child, each follow the same format and include a table of risk factors, guidance on when to refer the child for mental health treatment, as well as a flow chart to follow and use in determining whether the child should be referred to an emergency department for immediate evaluation. This design makes the book especially useful as an easy to use and quick reference as situations arise. The final two chapters provide valuable information on the kinds of resources available for children and the different services that may be provided in the emergency department when a crisis rises to the level of needing emergency care.—Rachel Lipson Glick, M.D., Clinical Professor, Department of Psychiatry, and Medical Director, Psychiatric Emergency Services, University of Michigan Health System

This book is a must-have for any health care provider who encounters children on a regular basis and who feels the need to be prepared for crises. It is particularly helpful for those in outpatient practice, pediatricians, and family practice providers, as well as school mental health providers.
Educators are apt to find the algorithms provided for each presenting problem particularly helpful; however, the language of the differential and some of the medical diction may be mismatched for their background. This book is likely less helpful for parents, as it is aimed at those who have some resources or base knowledge at hand. However, for an informed family—those with lived experience of crises and some background vocabulary of child mental health—I would not hesitate to recommend it. The algorithms, risk factor tables, and de-escalation techniques are thoughtful and clear. This book does not attempt to support everyone encountering kids in crisis—particularly missing an opportunity to speak more directly to educators or parents. That may have to wait for a future edition. However, for those of us in the pediatric mental health field needing a well-organized, pragmatic approach to how and when children need interventions, this is the book to own.—Kelly Ochoa, M.D., Brown University, Providence, Rhode Island, Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 58, Number 1, 01/01/2019

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