January 2021

The MLO Minute: By Jennifer Grobe, Esq.

Since the onset of the COVID-19 epidemic, there has been a considerable increase in the number of youths experiencing a mental health or psychiatric emergency. Disproportionately, children and adolescents with no prior psychiatric history have required emergency psychiatric evaluation.

 

Children and adolescents may be at risk of having a mental health crisis if they are exhibiting some or all of the following behaviors:

• rapid mood swings
• sleep disturbance
• eating disturbance
• poor hygiene
• isolating from friends and family
• increased agitation
• rapid speech
• seeming out-of-touch with reality
• hallucinations or delusions

 

If a caregiver suspects a child is an immediate danger to themselves or others, they should immediately seek emergency services. If possible, caregivers can take their child to the nearest emergency room for an emergency evaluation. If it is not possible to safely transport the child, the caregiver can call their county’s crisis intervention hotline for assistance. As a last resort, caregivers can call 911.

 

There are risks to getting law enforcement involved in a mental health emergency. The caregiver will lose their authority as primary decision-maker when police officers are sent in response to a 911 call or referral.  Officers responding to the call may take the child to the hospital for involuntary evaluation and/or commitment over the objection of the caregiver. They also may arrest the child and take them to a juvenile detention facility instead of an emergency room. There is no guarantee the officers who respond to 911 calls will have training or experience in responding to psychiatric emergencies.

 

WHAT TO TELL AN EMERGENCY RESPONDER WHEN SEEKING HELP FOR A PERSON EXPERIENCING A MENTAL HEALTH EMERGENCY

• Inform them a person is experiencing a mental health crisis.
• Specify what the person is doing or experiencing that led to the need for emergency services.
• If the person has a pre-existing mental health diagnosis, inform 911 that they have a disability and what disabilities they may have
• Request a responder who is trained to work with individuals experiencing a mental health crisis.

 

 

If a student is at-risk of having a mental health crisis, families, schools, health providers, and communities can prepare by coordinating and developing a Crisis Prevention and Response Plan. If a youth is already identified as a student with a disability, the Crisis Plan should be documented in their Individualized Education Program (“IEP”) or 504 Plan. If the child is not identified as one with a disability, the school district should re-evaluate for services. In certain situation, this evaluation may need to include a psychiatric evaluation.

 

A Crisis Prevention and Response Plan should include input from families, health care providers, and school teams that provides all of the necessary information to guide the adults in the child’s life who might have do help the child during a mental health emergency. The crisis plan should include relevant preventative information, specifying the child’s known triggers and known signs that the child is approaching a state of critical distress.

 

An effective crisis plan will guide the response of whoever is with the child when the emergency arises by including a hierarchy of appropriate responses and de-escalation techniques that have worked in the past. Relevant contact information should also be included in the plan including for the child’s therapist, psychiatrist, designated family members or friends, the local crisis line number, and local walk-in crisis centers or emergency rooms.