Saving Lives in Crisis: A Literature Review for Adolescent Crisis Response

INTRODUCTION: Only 50% of children with mental illnesses receive the appropriate mental health care, leading to an increase in acute hospitalizations for crisis events. Community-based psychiatric care programs, such as the Youth Assertive Community Treatment (Youth ACT) programs, offer a novel, community-based crisis intervention for adolescents with complex psychiatric needs. However, many times these programs experience capacity limitations due to staff burnout, stress, and low levels of competence as reported by staff. METHODS: Fifty-seven articles were screened for relevance, with 31 meeting inclusion criteria based on predefined appropriateness and exclusion standards. RESULTS: Despite many advances in pediatric psychiatry, crisis management remains a persistent challenge. This review found themes of crisis management guidelines for best practices, crisis management education, crisis management debriefing, crisis management tools, and the role of nursing in crisis management. Multiple trials found reduced hospitalizations and improved psychiatric symptoms with evidence-based guidelines and strategies. Education and debriefing opportunities improved staff self-perceived resilience and self-confidence ratings. CONCLUSION: Many programs struggle to provide crisis management that reduces psychiatric emergency department visits and hospitalizations. This review highlights how nurses can support crisis care staff by facilitating the recognition of guidelines, providing targeted education, designing crisis management tools, and offering structured debriefings.