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Crisis Interventions for Children and Adolescents with Depression and Suicidality: A Systematic Review and
Cristina Díaz-Téllez1,2, Inmaculada Peñuelas-Calvo3,4,5,6, Adrián Alacreu-Crespo7
1Department of Child and Adolescent Psychiatry, Hospital Clínic, Barcelona, Spain.
Purpose Of Review:
To review the evidence on crisis services for children and adolescents experiencing acute psychopathological crises, particularly severe depression, suicidal ideation, self-harm, and suicidal behaviour, and to examine their effectiveness in reducing symptoms, improving family functioning, and preventing hospitalisation.
Recent Findings:
A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. Searches of PubMed, Web of Science, PsycInfo, and ClinicalTrials.gov identified 15 eligible studies evaluating 15 crisis interventions. Four interventions targeted suicidal ideation and self-harm through brief, structured approaches, demonstrating reductions in suicidal thoughts, suicide attempts, and emergency department visits. Seven family-focused interventions (evaluated in eight studies) improved communication, family cohesion, and reduced hospitalisation rates. Three interventions aimed to stabilise crises and facilitate linkage with community services, improving continuity of care and decreasing emergency service utilisation. One residential intervention (evaluated in two studies) showed mixed findings, with some behavioural improvements but limited effects on internalising symptoms. Current evidence suggests that crisis services might be a promising alternative to hospitalisation for children and adolescents experiencing acute mental health crises. These interventions provide intensive support within the young person's natural environment, promote family involvement, and were associated with reductions in suicidal ideation, depressive symptoms, emergency visits, and hospital admissions. Despite promising findings, the evidence base remains limited, largely observational and heterogeneous, and causal conclusions cannot be drawn. Future research should directly compare different crisis service models and include long-term follow-up to determine the most effective approaches and their sustainability over time.
