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• understanding child and adolescent mental health problems • their social and developmental contexts • the management of common mental health problems in this age group • carrying out balanced risk assessments • liaison with social services and the role of other agencies • the legal context • confidentiality and child protection • diversity issues. Emergency Department Handbook The book includes contributions from professionals across a range of disciplines: paediatrics, child and adolescent psychiatry, liaison psychiatry, emergency medicine, and social care. The authors clarify the roles and responsibilities of every professional involved in the care of young patients and their families in a very vulnerable and potentially frightening situation. The book is intended for psychiatrists at all levels dealing with young people, paediatricians and emergency department clinicians, teachers and trainers, and the heads of department, managers and commissioners who work together to provide effective and efficient services to meet the needs of this under-served client group. The subjects covered include: Tony Kaplan This practical handbook covers everything a practitioner needs to know about dealing with children and adolescents who present in an emergency department with mental health problems. It provides an easily accessible framework of knowledge on child and adolescent mental health, with comprehensive, easy-tofollow guidance. � Emergency department Handbook Children and adolescents with mental health problems About the editor Tony Kaplan is a Consultant Child and Adolescent Psychiatrist at the Young People’s Crisis Recovery Unit, North London, and was Chair of the Royal College of Psychiatrists’ working group on CAMHS in the emergency department. Edited by PUBLICATIONS Tony Kaplan This page has been left blank intentionally Emergency Department Handbook Children and adolescents with mental health problems This page has been left blank intentionally Emergency Department Handbook Children and adolescents with mental health problems Edited by Tony Kaplan RCPsych Publications © The Royal College of Psychiatrists 2009 RCPsych Publications is an imprint of the Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG http://www.rcpsych.ac.uk All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing-in-Publication Data. A catalogue record for this book is available from the British Library. ISBN 978 1 901671 73 2 Distributed in North America by Publishers Storage and Shipping Company. The views presented in this book do not necessarily reflect those of the Royal College of Psychiatrists, and the publishers are not responsible for any error of omission or fact. The Royal College of Psychiatrists is a charity registered in England and Wales (228636) and in Scotland (SC038369). Printed by Bell & Bain Limited, Glasgow, UK. Contents Acknowledgements vii Contributors viii Abbreviations x List of tables, boxes and figures xi 1 Introduction Tony Kaplan 2 Contextual factors in assessing children and adolescents Helen Bruce 10 3 Emergency assessment and crisis intervention Tony Kaplan 19 4 Child and adolescent mental health presentations in the emergency department Josie Brown 1 33 5 Self-harm: issues, assessment and interventions Tony Kaplan 6