Practical Crisis Management for Parents and Clinicians: Adolescent Suicidal, Aggressive, Elopement Behaviours:...

In the many guidelines, recommendations and strategies for crisis management of suicide-related behaviours, aggression/vandalism and elopement in adolescents, immediately usable and specifically detailed descriptions and rationales of the strategies, especially for parents, are noticeably absent. This paper describes a feasibility project to develop one overall detailed strategy with specific adaptations for each of the three crises for adolescents in intensive services. It is a contribution to the discussion and joint service/parent management of these crises.

The factors to consider and the development of the strategy and PARENT GUIDE are described. Examples are provided. While the main work was done by the psychiatrist and staff of a day treatment service many other colleagues and families contributed over the seven years. The accompanying PARENT GUIDE is a necessary, separate and available document.

Since the purpose was to develop and evolve the strategy, it did not lend itself to a clear research outcome. However, careful estimates using the approximately 30 adolescents (of about 350 adolescents) for whom the strategy was used showed: no deaths, assault and vandalism stopped and elopement was managed. Parents regained skills, hope and improved relationships with their adolescents. They developed the confidence, specific knowledge and skills to manage for the future.

The successful development and evolution of the strategy demonstrated feasibility of the concept. The hope is that such strategies contribute to the advancement of patient care, the discussion in the literature and provide the basis for future research.