Evidence map›Paper›PMID 34218952›Full record

ArticleAnnals of emergency medicine2021

Treating Pediatric and Geriatric Patients at Risk of Suicide in General Emergency Departments: Perspectives From Emergency Department Clinical Leaders.

Cadence F Bowden, Gala True, Sara Wiesel Cullen, Miranda Pollock, Diana Worsley, Abigail M Ross, Jeffrey Caterino, Mark Olfson, Steven C Marcus, Stephanie K Doupnik

Open access · greenAbstract read
In one paragraph

Article in Annals of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Impact of telemental health on suicide prevention care in U.S. emergency departments.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Management of youth with suicidal ideation: Challenges and best practices for emergency departments.Journal of the American College of Emergency Physicians open · 2024
    Article
  9. Article
  10. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Cadence F BowdenDivision of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.
Gala TrueLouisiana State University Health Sciences Center-New Orleans School of Medicine, New Orleans, LA; Southeast Louisiana Veterans Health Care System, New Orleans, LA.
Sara Wiesel CullenSchool of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA.
Miranda PollockLouisiana State University Health Sciences Center-New Orleans School of Medicine, New Orleans, LA.
Diana WorsleyDivision of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.
Abigail M RossFordham University Graduate School of Social Service, New York, NY.
Jeffrey CaterinoDepartment of Emergency Medicine, The Ohio State University, Columbus, OH.
Mark OlfsonDepartment of Psychiatry, Columbia University, New York, NY.
Steven C MarcusSchool of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA; Center for Mental Health, University of Pennsylvania, Philadelphia, PA.
Stephanie K DoupnikDivision of General Pediatrics, Center for Pediatric Clinical Effectiveness, and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, University of Pennsylvania, Philadelphia, PA. Electronic address: doupniks@chop.edu.
Children's Hospital of Philadelphia · USUniversity of Pennsylvania · USColumbia University · USFordham University · USLouisiana State University Health Sciences Center New Orleans · USSoutheast Louisiana Veterans Health Care System · USThe Ohio State University · US

Funding

Improving the Emergency Department Management of Deliberate Self-HarmR01MH107452 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI MARCUS, STEVEN C, OLFSON, MARK · 2016 to 2020
$4.3M
Continuity of Mental Health Care after Youth Hospitalization for Suicide Attempt - Administrative SupplementK23MH115162 · NIMH · CHILDREN'S HOSP OF PHILADELPHIA · PI DOUPNIK, STEPHANIE · 2018 to 2021
$794k
NIMH NIH HHS K23 MH115162NIMH NIH HHS R01 MH107452
6 · The paper itself

Abstract

STUDY

objectiveWe explored emergency department clinical leaders' views on providing emergency mental health services to pediatric and geriatric patients with suicidal ideation and suicide attempts.

methodsWe conducted semistructured interviews with a total of 34 nursing directors, medical directors, and behavioral health managers at 17 general hospital EDs across the United States, using purposive sampling to ensure variation among hospitals. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using Atlas.ti and a directed content analysis approach.

resultsRespondents from across a range of ED types expressed concerns regarding the capacity of their EDs to meet mental health needs of children and older adults. They experienced emotional distress over the increasing number of pediatric patients presenting to EDs with suicidal ideation/suicide attempt and described EDs as inappropriate environments for young patients with suicidal ideation/suicide attempt. Similarly, leaders expressed feeling ill-equipped to diagnose and treat geriatric patients with suicidal ideation/suicide attempt, who often had medical comorbidities that complicated treatment planning. Respondents noted that pediatric and geriatric patients frequently boarded in the ED. Some felt compelled to use creative solutions to provide safe spaces for pediatric and geriatric patients. Respondents voiced frustration over the lack of outpatient and inpatient mental health services for these patients.

conclusionClinical leaders in EDs across the nation expressed distress at feeling they were not adequately equipped to meet the needs of pediatric and geriatric patients with suicidal ideation/suicide attempt. Future innovations to provide ED care for children and older adults with suicidal ideation/suicide attempt might include training for ED teams, access to specialist mental health clinicians through telehealth, and adaptations of physical spaces.

Indexed as

Attitude of Health PersonnelSuicidal IdeationSuicide, AttemptedAdolescentAdultAgedAged, 80 and overChildEmergency MedicineHumansMental Health ServicesMiddle AgedQuality of Health CareUnited StatesYoung Adult

Identifiers

PMID34218952
PMCPMC8546759
OpenAlexW3174876462

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.