Emergency evaluation of adolescents.

Psychiatric emergencies faced by adolescents are often linked to developmental issues such as separating from parents, establishing attachments to peers, and developing autonomy. In a vulnerable adolescent, a stressful developmental event may trigger a pathological response--acute anxiety, depression with or without suicidal ideation or behavior, severe conduct disturbance, a first psychotic episode, or explosive or violent behavior--that requires emergency psychiatric treatment. The basic components of an emergency psychiatric evaluation of an adolescent include initial observation of the patient, taking a history, interviewing the patient and others accompanying the patient, conducting a mental status examination, making a diagnosis, and planning for disposition and further treatment. Such an evaluation may be the first contact with the mental health system for many adolescents, and the intervention of a sensitive clinician may help the adolescent be more comfortable seeking mental health care in the future.