Case Example: How PMHCA Supports ED Teams in Real Time

Coordinating Care and Building Responsive ED Systems

This case example illustrates how PMHCA teams can use the toolkit with EDs to address pediatric mental and behavioral health needs in real-time. By following Jordan’s case, ED providers can see how PMHCA consultation, care coordination, and toolkit resources fit into their workflow, helping to strengthen their response and support better outcomes for children and families.

Patient Profile

Name: Jordan M.
Age: 13
Location: Rural ED with no on-site child mental health providers
Presenting Concern: Sent message to a friend: “I don’t want to be here anymore.”

  • ED nurse screens Jordan using the ASQ → positive result
  • Jordan is medically cleared and monitored in a secure, low-stimulation room
  • ED physician requests a behavioral health consult for guidance
  • ED physician contacts the PMHCA consultation line
  • PMHCA licensed mental health specialist provides real-time support on suicide risk, safety planning, and disposition to the provider and their team
  • PMHCA care coordinator:
    • Identifies an outpatient provider (clinical psychologist or counselor/social worker) in Jordan’s region
    • Aids ED in thinking through the coordination with Jordan’s PCP
    • Helps resolve insurance access issues
  • ED social worker uses PMHCA templates to complete a comprehensive evaluation assessment
  • PMHCA licensed mental health specialist confirms moderate risk, suggests outpatient follow-up appropriate with close parental supervision
  • Strong family support is noted as a protective factor
  • ED team works with Jordan and their mother to create a collaborative safety plan
  • PMHCA may partner with the ED in helping their team arrange the following:
    • Tele-mental health appointment within 48 hours
    • Referrals to tailored and responsive resources
  • With parental permission, a summary of care is sent to Jordan’s PCP and documented in the electronic medical record
  • ED staff debrief the case using PMHCA’s structured review tools
  • Insights from the case inform future training and protocol updates, strengthening the ED's response for similar situations

See PMHCAs at Work

Contributions by Function

Function Role in Jordan’s Case

Consultation

Licensed child mental health specialist advised on risk and disposition

Care Coordination

Identified outpatient providers, assisted with access barriers

Templates and Tools

Provided safety plan and risk stratification forms

Family Support

Connected Jordan’s caregiver to crisis and community resources

Training and QI

Case used in team debrief and future onboarding sessions
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