Crisis services for young people may reduce admissions and emergency visits

Design

Systematic review of 15 studies, largely observational

Population

Children and adolescents in acute mental health crisis

Primary outcome

Symptoms, family functioning and hospitalisation

Effect

Associated with fewer suicidal thoughts, emergency visits and admissions; no pooled estimate

A systematic review identified 15 studies of crisis interventions for children and adolescents with acute mental health crises, including severe depression, suicidal ideation, self-harm and suicidal behaviour.

Brief structured interventions targeting suicidal ideation were associated with fewer suicidal thoughts, attempts and emergency visits. Family-focused interventions were associated with better family communication and fewer hospital admissions, and services linking young people to community care improved continuity. A residential model showed mixed results.

The authors stress that most studies were observational and heterogeneous, so causal claims cannot be made. For family physicians, the practical point is that the family is part of the treatment, and that a structured safety plan and a firm link to follow-up are worth arranging before the young person leaves the room.

• Involve the family in crisis planning for a young person with suicidal thoughts, where safe to do so.
• Agree a written safety plan, including means restriction and who to contact.
• Arrange a specific follow-up appointment rather than open-ended advice to return.
• Know the local crisis and child mental health services before you need them.

Why it matters

Hospital is not the only safe place for a young person in crisis, and family-based alternatives may work as well or better.

Don't overread it

The evidence is largely observational and heterogeneous; it cannot show which model works best.

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