Children's stress often overlooked in emergency rooms

Emergency medical care workers, from paramedics to trauma surgeons, met at APA headquarters recently to discuss ways they can help prevent children from leaving the emergency room with post-traumatic stress in addition to stitches or a cast.

The group's goal is to better address the emotions that accompany a child's visit to the emergency room, such as guilt, shock, fear, anger, self-consciousness and confusion.

"Mental health needs are not being followed up," said Jack Bergstein, MD, a trauma surgeon in Peoria, Ill. "This increases cost through later medical and mental health hospitalization and can result in death and disability."
APA invited 17 health professionals from all over the United States--including emergency physicians, trauma surgeons, emergency nurses, social workers, psychologists, psychiatrists and emergency medical technicians--to the consensus conference, "Mental Health Needs of Children Involved in the Emergency Medical System," held June 14-15.

Part of the reason children's stress is overlooked, the group says, is that emergency medical workers are inadequately trained in the psychological effects of emergencies. Also, emergency department staff rarely inquire about a child's emotional needs when they follow up with parents on a child's medical condition, and links between emergency departments and mental health and community services are weak.

The group agreed on better training and more aggressive follow-up procedures to improve care. But they also concluded that more research is needed on the long-term effects of emergency room visits on children and the cost of training emergency medical workers to better assess children's mental health needs.

They also recommended that emergency-care workers and mental health professionals: