Emergency Child and Adolescent Psychiatry: Self-Harm, Suicidal Crisis and Acute Behavioural Emergencies
Guidance for recognising and responding to psychiatric emergencies in children and adolescents, including suicidal crisis, self-harm, and acute behavioural or psychotic emergencies.
Certain situations in child and adolescent mental health represent genuine emergencies, requiring immediate evaluation rather than a routine appointment. Recognising these situations and responding promptly can be life-saving.
This page outlines emergency situations in child and adolescent psychiatry and the steps to take. It does not replace immediate emergency care when a crisis is occurring right now.
Situations Requiring Immediate Emergency Care
- Suicidal crisis — a child or adolescent expressing suicidal thoughts with intent or a plan, or a suicide attempt
- Significant self-harm requiring immediate medical attention
- Severe agitation or aggression with risk of harm to self or others
- Acute psychosis or severe confusion in a young person
- A severe, acute reaction following a traumatic or frightening event
What to Do in a Crisis
- If there is immediate danger to life, go to the nearest emergency department or call emergency services without delay
- Do not leave a child or adolescent alone if there is a risk of self-harm
- Remove access to means of self-harm where safely possible
- Stay calm and reassure the young person that help is available
- Contact a child psychiatrist or crisis service urgently if the situation is escalating but has not yet reached the point of calling emergency services
Supporting a Child or Teenager Through a Crisis
Following an acute crisis, urgent assessment establishes the underlying cause, immediate treatment and safety needs, and a collaborative safety plan involving both the young person and their family, alongside close follow-up during the period of highest risk.
A Note for Parents
Witnessing a child or adolescent in crisis is frightening for any parent. Responding calmly, taking every warning sign seriously, and seeking prompt professional help gives your child the best chance of a safe, full recovery.
Frequently Asked Questions
Frequently Asked Questions
Should I take my child's talk of suicide seriously even if it seems like an exaggeration?
Yes, any mention of suicide should always be taken seriously and assessed professionally, rather than dismissed as attention-seeking or exaggeration.
Will asking my child directly about suicidal thoughts make things worse?
No, research consistently shows that asking calmly and directly about suicidal thoughts does not increase risk, and instead opens the door to getting help.
What happens after an emergency assessment?
Following stabilisation, ongoing care is arranged, including a clear safety plan, appropriate treatment, and close follow-up with both the young person and family closely involved.
Expert Care
Dr. Muhammad Shoaib Zafar provides urgent, compassionate care for children and adolescents in crisis, working closely with families to ensure safety and support recovery.
If your child or teenager is in immediate danger or has a plan to harm themselves, please go to the nearest emergency department or call emergency services right now. This page is educational and does not replace urgent professional care.
Common signs & symptoms
- Suicidal thoughts, plans, or a suicide attempt
- Active self-harm with significant injury
- Severe agitation or risk of harm to self or others
- Acute psychosis or severe confusion in a child or teenager
- Extreme behavioural crisis with danger to safety
- Severe reaction to trauma or a frightening event
Treatment approach
- → Immediate emergency evaluation
- → Safety planning involving the young person and family
- → Urgent treatment initiation where indicated
- → Coordination with emergency medical services
- → Close follow-up during the highest-risk period
Frequently asked questions
Should I take my child's talk of suicide seriously even if it seems like an exaggeration?
Yes, any mention of suicide should always be taken seriously and assessed professionally, rather than dismissed as attention-seeking or exaggeration.
Will asking my child directly about suicidal thoughts make things worse?
No, research consistently shows that asking calmly and directly about suicidal thoughts does not increase risk, and instead opens the door to getting help.
What happens after an emergency assessment?
Following stabilisation, ongoing care is arranged, including a clear safety plan, appropriate treatment, and close follow-up with both the young person and family closely involved.