(PS8-A15) Parents’ Experiences in the Pediatric Emergency Department During Their Child’s Mental Health Emergency

The utilization of emergency departments (ED) for psychiatric emergencies in adolescents has consistently been on the rise (Plemmons et al., 2017). Parents/caregivers are key stakeholders in this setting. They are often alongside their child when they present for a psychiatric emergency, and parents are tasked with monitoring and managing their child’s mental health upon ED discharge. While there are adolescent focused ED interventions to reduce risk after ED discharge (e.g., safety planning for suicide; Asarnow et al., 2011) ,no evidence-based interventions exist to support parents of children seeking psychiatric emergency care. Research to understand parents’ experiences during their child’s psychiatric ED visit is limited. One study found that parents report feeling isolated and excluded during hospitalization and in the months after ED discharge (Clarke & Winsor, 2010), and these families can fall into a cycle of relying on the ED for psychiatric care, suggesting the need to offer more support to parents and caregivers  when their child is discharged (O’Keefe et al., 2021). The present study aims to examine parent experiences (both positive and negative) in the pediatric ED setting during their child’s psychiatric emergency to inform the development of parent-focused ED interventions.

We interviewed N=13 parents within 1-month of their child’s psychiatric ED visit (ages 21-48;73% White; 27% Black; 9% Iranian American). Semi-structured qualitative interviews probed their experiences leading to their child’s ED visit, during their ED admission, and after discharge from the hospital. The present study focuses on themes identified during their child’s ED admission. Interviews were audio recorded and transcribed for coding. Authors MP, KB, and AB developed and refined the codebook through a series of meetings; interviews were then coded by 2 independent coders who met for consensus.

Themes identified fell into three broad categories: (1) impact of ED admission on their child, (2) the nature of interactions with the ED staff and hospital system, and (3) parents’ attitudes toward, emotions in response to, and understanding of their child’s mental health. Themes highlight strengths of our current ED system, including parents’ positive interactions with ED staff who were overall perceived to be caring and compassionate. Themes also highlight areas where intervention during this high-risk period could be improved, including maximizing this opportunity to provide parents with psycho-education about mental health and the need for crisis spaces that are designed with mental health needs in mind Finally, themes also highlight parents’ resilience in the face of adversity.

Parents are key stakeholders to consider during a child’s psychiatric emergency, yet limited resources are in place to support parents during and after a crisis. The present study focused on major themes that emerged when parents described their experiences in the ED setting during their child’s mental health crisis. Findings can inform improvements in our pediatric ED setting that may benefit families seeking psychiatric support, and point toward the importance of providing parents with support in addition to support for the child in crisis