APA working to improve medical services for kids

With a federal grant, APA will develop a resource for emergency workers.

By Scott Sleek
Monitor staff

APA has received an $87,000 contract from the federal government to improve health professionals? access to information about children?s psychological needs in medical emergencies.

The Emergency Medical Services for Children (EMSC) program of the federal Maternal Child and Health Bureau awarded the contract to APA?s Public Interest Directorate as part of an effort to better understand children?s needs in emergency settings. EMSC and APA hope the increased knowledge will spawn improvements in the emergency medical and psychological services those children receive.

'We?re not just interested in mental health emergencies, such as attempted suicide or children having a psychotic episode,' says Isadora Hare, who is APA?s manager on the project. 'We also want to know more about kids who come into the emergency room with medical emergencies and trauma, and what the mental health correlates are: What?s it like for them to be placed in an ambulance or subjected to emergency medical procedures? What makes the experiences less frightening for them?'

Under the contract, APA plans to develop a bibliography of research on psychological and behavioral aspects of emergency medical care for children, such as the long-term emotional reactions children experience after they?re physically injured or rushed to the hospital in an ambulance. The Public Interest Directorate will work with APA?s Books and Journals departments to create the bibliography and hopes to have up to 700 entries, says Hare. The project is due to be completed by next September.

The bibliography will be designed for mental health personnel, including psychologists, social workers and nurses, who work in emergency medical settings. It will also be designed for health-care administrators who plan emergency services.

'It will give us a kind of a state-of-the-art assessment of what we know and need to know about emergency services for children,' says Jean Athey, PhD, director of the EMSC program. 'And that can help influence research as well as the services that are provided.'

The bibliography will contain data on children who need emergency care because of mental disorders and on the psychological impact that children experience when they?re treated for medical emergencies.

The directorate is forming a small advisory group of APA members to guide the development of the bibliography, Hare says. The group and EMSC must consider how to make the bibliography accessible to providers once it is complete, she adds, noting that it is likely to be available electronically.

Also under the contract, the directorate will host a multidis-ciplinary conference next spring to discuss the mental health needs of children who have experienced a medical emergency. Emergency medical technicians, emergency room nurses and physicians, trauma surgeons and mental-health staff will be among the providers invited to attend the meeting, which will be held in Washington, D.C., Hare says. The participants will examine the emotional impact that emergencies have on children and their families and will identify relevant issues that need to be studied.

The directorate has already provided consultation work to EMSC under a 1996?97 contract. As part of that project, the directorate offered several recommendations for including violence prevention in children?s emergency medical care. It suggested, for example, that emergency-medical professionals be trained to recognize signs of child abuse and neglect in patients they treat, as well as the emotional trauma inflicted on children who witness violence in their homes or communities.