espond to at your colleague by recommending at least one additional way you would treat a child or adolescent client differently than you would an adult and at least one additional way you would address the legal and ethical issues involved.
A Psychiatric Emergency
The client is a 36-year-old unemployed Mexican male who is estranged from his wife due to domestic violence. He is wife have recently filed for a divorce and the proceedings are in one week. Client presented to the clinic with his mother and sister with complaints delusional thoughts, extreme paranoia and a presentation of a psychotic episode. It was determined by my preceptor and other clinical staff that this client will require admission to an inpatient behavioral health unit to ensure his safety and to establish baseline stability. Furthermore, this client has a history of refusing to take his medications which were prescribed to him for substance induced mood disorder. The client and his family agreed that it was necessary for us to call for emergency medical services (EMS) for transport to hospital to be thoroughly evaluated and treated. He was also informed that he would most be admitted through the emergency room (ER) for med clearance and then he would be transferred to the behavioral health unit. Although this client has extreme elevated paranoia and anxiety, he denies suicidal / homicidal ideations. Client and his family are cooperate.
Legal and Ethical Considerations for Children
The case study above proves that the treatment for an adult in a psychiatric emergency situation can require family and friends to be present for support however, they are unable to make the ultimate decision for treatment. In contrast, children in a psychiatric emergency would need the participation of their parents or guardians not only for support but, to obtain clear pertinent information. However, in some states, adolescents are able to seek treatment for mental health and/or substance abuse issues without parental consent (Kerwin et al., 2015). Furthermore, confidentiality must be kept with adolescents as it is with adults, unless it is a situation where the child is a threat to themselves or someone else (Vallance, 2016). Lastly, if the parents or guardians are not in agreement with utilizing mental health services as an intervention strategy for a child that is in imminent danger, the provider and clinical staff should make the decision and disregard the opposition (Sondheimer, 2010).
Kerwin, M. L. E., Kirby, K. C., Speziali, D., Duggan, M., Mellitz, C., Versek, B., & McNamara, A. (2015). What can parents do? A review of state laws regarding decision making for adolescent drug abuse and mental health treatment. Journal of Child and Adolescent Substance Abuse, 24(3), 166-176.
Sondheimer, A. (2010). Ethics and Child and Adolescent Psychiatry. Retrieved 2 October 2019, from https://www.psychiatrictimes.com/child-adolescent-psychiatry/ethics-and-child-and-adolescent-psychiatry
Vallance, A. (2016). ‘Shhh! Please don’t tell…’ Confidentiality in child and adolescent mental health. BJPsych Advances, 22(1), 25-35. doi:10.1192/apt.bp.114.013854
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