Psychiatric emergency in childhood: connecting territorial and hospital services

Key words: Psychiatry, Paediatrics, Adolescence, Psychiatric emergency, Hospital admission

Neuropsychiatric services usually take care of children and adolescents with mental disease as outpatients. Although hospital admission for psychiatric disorders is infrequent, the number of children and adolescents who arrive to emergency departments in acute psychiatric crisis is increasing. Dedicated inpatient mental services for childhood are few and not enough to take care of all patients in psychiatric emergency. A high proportion of children are admitted to paediatric or adult medicine wards as well as to inpatient psychiatric services for adults. Hospitals, in which a childhood psychiatric service is lacking, must adopt clinical and organizing procedures to assure appropriate care in a pediatric environment with the fundamental contribution of territorial mental and social services. A network should be created that allows the continuity of care during the stay in hospital and after dismission. This paper describes an experience of inpatient care of psychiatric acute illnesses in a paediatric department focusing on main problems encountered and on possible solutions.