Checklist before discharging an adolescent who has attempted suicide Before discharging a patient from the emergency room or crisis centre always

• Check that firearms and lethal medications have been secured or removed

• Check that there is a supportive person at home

• Check that a follow-up appointment has been scheduled

Acute psychiatric inpatient care should be reserved for patients for whom intensive surveillance and intervention are considered essential—as in the presence of active suicidal ideation and intent or when the youngster is unable to commit to not carrying out a suicidal act, when the youth is unpredictable, impulsive, agitated, or psychotic, or if there is a lack of support and supervision in the home. There is no evidence that exposure to other suicidal psychiatric inpatients increases the risk of suicidal behaviour. Determining when a patient is ready for discharge from the hospital or crisis centre will usually include an evaluation of the severity of existing suicidal ideation and intent. Implicit coercions (e.g. telling patients that discharge will be delayed until they can state that they are not suicidal) should be avoided.

Treatment compliance may be improved by offering definite, closely spaced, follow-up appointments, being flexible in arranging appointments if a crisis should arise, and reminding the family and patient by telephone or note about the next appointment. If an appointment is missed, the patient and parent should be contacted. Hopeless and depressed children and adolescents, who may be not be able to commit to a lengthy treatment process, may be better engaged by offering short-term treatment plans with defined intervention goals. While offering confidentiality for some issues, it is essential that the clinician communicate to the patient that, if they feel that suicidal thinking or behaviour is imminent, such information will be shared with the parents.

Funny Wiring Autism

Funny Wiring Autism

Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

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