Pediatric emergency medicine trisk 4184 4184
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TABLE 126.17
CHILDHOOD AND ADOLESCENT SUICIDE: ASSESSING
STRENGTHS AND SUPPORTS
Strengths and assets of child
Ability to relate to physician
Ability to rely on parents in crisis
Ability to acknowledge problem
Positive orientation toward future
Strengths and assets of family
Commitment to child
Ability to unite during crisis
Problem-solving abilities
Capacity to supervise child (support and limits)
Ability to use external supports
Nature of external supports
Outpatient psychiatrist/family physician
Extended family
Neighbors/other significant adults
Religious community
Self-help groups
Any suicide attempt deserves a thorough assessment by the emergency
physician and a complete psychiatric consultation. Hospitalization should be
used in the circumstances listed in Table 126.19 .
Initiating Treatment. If inpatient treatment is required, the child and family
should be informed about the goals of hospitalization and the active role of
the family in the treatment emphasized. Instances in which the child or
parents do not agree to hospitalization, involuntary commitment may be
needed as a last resort.
Outpatient management of suicidal behavior becomes feasible when (i)
the child and family are cooperative and engageable; (ii) the attempt is
determined not to have been too serious in terms of intent/medical lethality;
