What to Expect at the Emergency Department
If you don’t believe your child will be safe,
do not sign the release from the
emergency department.
Emergency Department Workers Will:
- Stabilize and assess the patient (your child).
- Decide if there is an urgent danger from suicidal thoughts or a risk of harm to self or others.
- Make clinically-informed plans for follow-up treatment
When You Are at Check-In
- Explain what happened, why you are there and what you need.
- Provide basic information. Include name, address and insurance.
- Have the following with you in the emergency department:
- All medications, or a list of medications that your child is taking.
- Your child’s health history.
- Names and phone number of your child’s primary care provider, therapist, and other health providers.
If you did not bring this information, call someone to bring it to you.
Set up information in a portable file you can quickly grab or keep with you if you need it in the future.
Medical Health Assessment
Emergency department staff will conduct an assessment that focuses on four areas:
- General medical assessment
- Blood pressure, temperature, etc.
- Overall physical condition
- This includes possible side effects of medicines or other drugs.
- Suicide attempt circumstances
- What your child did to harm themself
- History of attempts
- If there was a suicide note
- What might have prompted the attempt (relationships with friends, school, family, etc.)
- Overall mental state
- How your child feels now (disappointed, angry, relieved, etc.)
Mental Health Assessment
The health professionals will assess the level of urgency for possible psychiatric admission. One or more of the following may ask you to speak with them in a private room:
- Emergency Department Doctor
- Psychiatrist
- Psychiatric Nurse
- Mental Health Crisis Worker
For your child’s safety, they may be in a psychiatric hold room while they wait for a mental health assessment. These rooms are a relatively bare
space. Medical staff may ask the child to change into a gown, scrubs, and slippers.
Questions from the person making the assessment may include:
- Why did you bring your child to emergency today?
- Did anything different than normal happen today or during the past week?
- Has your child attempted suicide before?
- Does your child have a history of harmful behavior (cutting, overdose, drug, or alcohol use)?
- Are there any recent or near future events that distress your child?
- Do you know of anything that may have prompted the attempt?
- Is there abuse or a possibility of abuse, including bullying?
Is it occurring at school, in the home or somewhere else? - How is your child doing at school?
- Is there a family history of mental illness, addiction or suicide?
Are there medicines that helped that family member?
Suicide Risk Assessment
The emergency staff will assess your child’s risk for suicide. This is more than just asking your child if they are actively thinking about suicide. A child may not have suicidal thoughts in the safety of a hospital. However, they may be at risk of an attempt again after returning to stresses at home or at school. An assessment should include:
- Reviewing current medications, including any alcohol or illegal drug use
- Setting up follow-up care, which includes:
- The ability to look after themselves
- Need for peer support, and
- Other community-based services
- Thinking about what happens after the emergency department visit. This includes returning home or moving to other levels of care
You may hear about risky behavior or something you did not know about. Hearing this may be shocking. Try your
best to not show a reaction or ask for more details. Instead, make sure the safety plan covers the behavior. You will
have a chance to address your own emotional shock and concerns after the immediate crisis.
How to Advocate for You and
Your Child in the Moment
Be clear about why you are in the emergency department and what you want for your child.
Ask questions about the safety plan and follow-up care. If the hospital wants to release your child to go home and you don’t feel you can keep them safe, listen to your instincts. Clearly explain your reasons. Is your child at risk to themselves or others? Will your child be alone at times during the day or night?
If you do not believe your child will be safe, do not sign the release from the emergency department.
Contact the hospital patient advocate and the Oregon Health Authority ombudsperson immediately. File a complaint documenting your objections.