What to Expect at the Emergency Room

When You Are at Check-In

  • Explain what happened, why you are there, and what your youth needs. 
  • Provide basic information, including name, address and insurance.
  • Have the following with you in the emergency room:
    1. All medications, or a list of medications your
      youth is taking.
    2. Your youth’s health history, including mental
      health diagnosis, if there is one.
    3. Names and phone number of your youth’s doctor, therapist, and other professionals that your youth
      sees for their mental health or substance use concerns.

    If you did not bring this information, ask someone to bring it, or text it, to you. It can help to keep this information in one place so you can grab it quickly if you need it in the future

Emergency Room Staff Will:

  • Assess and medically stabilize, if needed. This could include taking blood, connecting machines and attaching an intravenous (I/V) line.
  • Decide if there is immediate danger from suicidal thoughts or risk of harm to self or others.
  • Make medically-informed plans for follow-up care.

Medical Health Assessment

Emergency room staff will complete an assessment that looks at three main areas:

  • General medical assessment
    • Blood pressure, temperature, and other basic checks.
    • Overall physical health.
    • Possible side effects from medications or other substances.

    For safety reasons, your youth may wait in a psychiatric hold room. These rooms are simple and may not have many items. Staff may ask your youth to change into a gown or scrubs, and socks. All Emergency Rooms have warmed blankets, you can ask for this, if necessary or helpful.

    Mental Health Assessment

    Health professionals will decide how urgent your youth’s mental health needs are. One or more of the following may ask to speak with your youth in a private room:

    • Emergency Room Doctor
    • Psychiatrist
    • Psychiatric Nurse
    • Mental Health Crisis Worker
    •  

    Questions During the Assessment may Include:

    • Why did you bring your youth to the emergency room today?
    • Did anything different happen today or during the past week?
    • Has your youth tried to harm themselves before?
    • Does your youth have a history of unsafe behavior, such as cutting, overdose, or substance use?
    • Are there events coming up that are causing your youth stress?
    • Do you know what may have led to this crisis?
    • Is there abuse or bullying, at school, at home, or somewhere else?
    • How is your youth doing at school?
    • Is there a family history of mental illness, addiction, or suicide?
    • Were there treatments or medications that helped family members?

     

    Suicide Risk Assessment

    Emergency staff will assess your youth’s risk for suicide. This is more than asking if your youth feels suicidal right now. A youth may feel safer in the hospital but still be at risk later when stress returns at home or school.

    The assessment will include:

    • Overall mental state
      • How your youth feels now, such as angry, sad, relieved, or overwhelmed.
    • Current medications
    • Alcohol or drug use

    Planning follow-up care, including:

    • Ability to care for themself.
    • Need for peer support.
    • Other community-based services.
    • Planning what happens after emergency room visits, such as going home or moving to another level of care.

     

    You may hear about behaviors or concerns you did not know about. This can be shocking. Try to stay calm and focus on making sure the safety plan addresses these concerns. It is okay if your feelings take time. You can return to them when you are ready.

    How to Advocate for You and Your Youth in the Moment

    Be clear about why you are in the emergency room and what you want for your youth.

    Ask questions about the safety plan and follow-up care. If the hospital wants to send your youth home this can feel scary and overwhelming. Be sure to explain all your concerns about keeping your child safe. Work with the hospital on what are the negatives and positives – the risks and what strengths or supports could help you and your child handle challenges and get through difficult times. It is important to keep talking and listening, especially as they explain how they have assessed the risks and balanced any decisions. You may also need to say things multiple times and you may disagree with their decision.

    Ask yourself:

    • How much risk is there that my youth will harm themselves or others?
    • Are we able to manage this? 

     

    If you do not believe your youth will be safe, say so.

    Speaking up and helping your team understand your concerns is important.  If you say you cannot take your youth home because of safety concerns, Child Protective Services (CPS) may be contacted. If this happens, do your best to stay calm.

    CPS does not want to take custody of a child when there is someone who can safely care for them. 

    If you do not feel your concerns are being heard, you can:

    • Ask for a social worker or the hospital patient advocate.
    • Call the Oregon Health Authority ombuds team as soon as possible (1-877-642-0450) – This is a message line only.
    • File a complaint that clearly explains your concerns.
    • Call the Reach Out Oregon Parent Warmline
      (1-833-732-2467), Monday through Friday from 10am to 4pm and ask the Family Support Specialist to help you think through next steps.