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Published Online: 1 June 2017

Management of Mental Health Crises Among Youths With and Without ASD: A National Survey of Child Psychiatrists

Abstract

Objective:

This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD).

Methods:

A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis. Child psychiatrists reporting on management of youths with ASD (N=492) and without ASD (N=374) completed the survey.

Results:

About 75% of psychiatrists in both groups were willing to accept a child with a history of a mental health crisis in their practice. During a crisis, psychiatrists caring for youths with ASD had less access to external consultation resources, such as a crisis evaluation center or other mental health professionals, compared with those caring for youths without ASD. Psychiatrists also expressed concerns about the ability of emergency department professionals and emergency responders to manage mental health crises among youths in a safe and developmentally appropriate manner, particularly among those with ASD.

Conclusions:

Child psychiatrists are in need of more external resources to manage youths with ASD who are experiencing a mental health crisis. There is also a need to develop best practice procedures for emergency responders who are working with youths experiencing a mental health crisis.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Birmingham Breakdown #2, by Craig Moran, 2010. Oil on canvas. Collection of the artist, Washington, D.C.

Psychiatric Services
Pages: 1039 - 1045
PubMed: 28566025

History

Received: 18 July 2016
Revision received: 22 November 2016
Revision received: 31 January 2017
Accepted: 3 March 2017
Published online: 1 June 2017
Published in print: October 01, 2017

Keywords

  1. Autism
  2. Community mental health services
  3. Crisis intervention
  4. Child psychiatry/developmental
  5. Epidemiology

Authors

Details

Luther G. Kalb, M.H.S. [email protected]
Mr. Kalb and Dr. Stuart are with the Department of Mental Health, and Dr. Stuart is also with the Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Mandell is with the Department of Pediatrics and the Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia. Dr. Olfson is with the Department of Psychiatry, Columbia University, New York. Dr. Vasa is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, and with the Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.
Elizabeth A. Stuart, Ph.D.
Mr. Kalb and Dr. Stuart are with the Department of Mental Health, and Dr. Stuart is also with the Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Mandell is with the Department of Pediatrics and the Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia. Dr. Olfson is with the Department of Psychiatry, Columbia University, New York. Dr. Vasa is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, and with the Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.
David S. Mandell, Ph.D.
Mr. Kalb and Dr. Stuart are with the Department of Mental Health, and Dr. Stuart is also with the Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Mandell is with the Department of Pediatrics and the Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia. Dr. Olfson is with the Department of Psychiatry, Columbia University, New York. Dr. Vasa is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, and with the Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.
Mark Olfson, M.D., M.P.H.
Mr. Kalb and Dr. Stuart are with the Department of Mental Health, and Dr. Stuart is also with the Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Mandell is with the Department of Pediatrics and the Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia. Dr. Olfson is with the Department of Psychiatry, Columbia University, New York. Dr. Vasa is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, and with the Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.
Roma A. Vasa, M.D.
Mr. Kalb and Dr. Stuart are with the Department of Mental Health, and Dr. Stuart is also with the Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Mandell is with the Department of Pediatrics and the Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia. Dr. Olfson is with the Department of Psychiatry, Columbia University, New York. Dr. Vasa is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, and with the Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.

Notes

Send correspondence to Mr. Kalb (e-mail: [email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Autism Speaks10.13039/100000073: TG- 8790
This study was funded by Autism Speaks.

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