Pediatric Psychiatric Emergencies: When a Child Needs an ER, Crisis Bed, or Inpatient Admission

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Maya Reynolds, fourteen, sat in the children’s emergency department in Newark on a Tuesday night, holding her mother’s hand and waiting. Maya had told her school counselor that morning that she had been thinking about her stepfather’s pistol for the last week, that she had Googled how to load it, and that she had stood … Read more

After the Psychiatric ER: A Practical Guide to the First 48 Hours, Medications, and Follow-Up Mental Health Care

The Discharge Most Patients Are Not Ready For The American psychiatric emergency department is a remarkable but limited intervention. It can keep a person alive through a crisis, run urgent labs and toxicology, restart medications, and sometimes negotiate an inpatient admission. What it cannot do is provide the kind of continuous mental health care a recovering patient … Read more

After the Psychiatric ER: A Practical Guide to the First 48 Hours, Medications, and Follow-Up Mental Health Care

The Discharge Most Patients Are Not Ready For The American psychiatric emergency department is a remarkable but limited intervention. It can keep a person alive through a crisis, run urgent labs and toxicology, restart medications, and sometimes negotiate an inpatient admission. What it cannot do is provide the kind of continuous mental health care a recovering patient … Read more

Refeeding Syndrome: Recognising and Preventing the Sometimes-Fatal Complication of Eating Disorder Recovery

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Hannah was 16, admitted to Cincinnati Children’s Hospital after months of restrictive eating that ended with a heart rate of 38 and a potassium of 2.7. Her parents, who had been begging her to eat for nearly a year, finally exhaled when she sat at the meal tray on day two and finished her oatmeal. … Read more

Refeeding Syndrome: Recognising and Preventing the Sometimes-Fatal Complication of Eating Disorder Recovery

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Hannah was 16, admitted to Cincinnati Children’s Hospital after months of restrictive eating that ended with a heart rate of 38 and a potassium of 2.7. Her parents, who had been begging her to eat for nearly a year, finally exhaled when she sat at the meal tray on day two and finished her oatmeal. … Read more

Catatonia: Recognition, Lorazepam Challenge, and ECT for the Most-Missed Psychiatric Emergency

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Eleanor, a 62-year-old retired schoolteacher from Asheville, North Carolina, had been in the geriatric psychiatry unit for nine days with a diagnosis of severe major depression. She would not eat. She would not speak. She lay in the same position for hours, her right arm raised slightly off the mattress as if she had been … Read more

Catatonia: Recognition, Lorazepam Challenge, and ECT for the Most-Missed Psychiatric Emergency

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Eleanor, a 62-year-old retired schoolteacher from Asheville, North Carolina, had been in the geriatric psychiatry unit for nine days with a diagnosis of severe major depression. She would not eat. She would not speak. She lay in the same position for hours, her right arm raised slightly off the mattress as if she had been … Read more

Mobile Crisis Teams Explained: How to Reach Clinical Help Without Calling 911 or the ER

The Phone Number That Could Have Saved a Trip to the ER Most Americans, when faced with a mental health care crisis at home, have exactly two phone numbers in their head. They call 911, which usually dispatches police and an ambulance, or they drive their loved one to the nearest emergency room. Both responses are blunt … Read more

Pregnancy Mental Health Crisis: Anxiety, Depression, and Suicidality Before Delivery

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Sofia was twenty-nine, a graphic designer in Minneapolis, when her midwife noticed something during her 28-week prenatal visit. Sofia had been crying in the waiting room. She had lost weight that pregnancy week instead of gaining. She told the midwife she was fine, the pregnancy was wanted, the partner was supportive, and she was just … Read more