Pediatric Behavioral Health Video and Podcast Series
Resource leader: Melissa Sundberg MD
Team members: Thomas Balga, PA-C, Kristen L. Campbell, CPNP, Maureen Cooper, Michael P. Goldman, MD, Zhaela Qayyum, MD, Jennifer Schlebusch, Dax Sousa, CPRN
We're excited to have a series of videos focused on pediatric behavioral health topics! The purpose of these videos is to introduce you to general topics in pediatric behavioral health, but there are also some short videos on the approach to specific populations of patients who present with behavioral health conditions. For videos 1-4, we have provided a time index of the topics covered in each video. While our general recommendation is to watch all the videos in their entirety, we understand that it can be difficult to watch every video from start to finish. We have provided the index so you can watch the portions you feel would be most valuable to you.
The current video series includes:
- Video 1 and 2: General introduction to Pediatric Behavioral Health (Video 1: School Age, Video 2: Adolescent)
- Video 3: Behavioral Patients: Coping and Common Triggers
- Video 4: Bringing Pediatric Inpatient Psychiatric Medication to your Emergency Department: Understanding, Starting, or Adjusting Therapy for Psychiatric Boarders
- Video 5: Approaching a Pediatric Patient with Psychosis (coming soon!)
- An Email to send to ED staff to introduce and encourage video viewing.
Video 1 and 2: General Introduction to Pediatric Behavioral Health
An overview of pediatric behavioral health conditions in school aged children and adolescents
These introductory videos by Maureen Curtis-Cooper are a general introduction to pediatric behavioral health conditions. The first video reviews school age children with behavioral health conditions and the second video reviews the adolescent age group. For each group and condition, Maureen provides a general overview, epidemiology, and review of approach and treatment.
Maureen Curtis-Cooper is a pediatric emergency nurse educator at Boston Medical Center, serving on the board for the Massachusetts Pediatric Emergency Nurses Association (ENA) as well as serving on the national committee for course development for pediatric emergency nursing. She developed the introduction series below.
Video 1 Index: School Age Behavioral Health
0:00 to 10:30: General overview
This includes a general overview of the behavioral health population in pediatrics including the general population numbers, length of stay, diagnosis typical seen/presentations and impact of COVID.
10:30 to 2330: General approach
The general approach to the pediatric patient with a behavioral health condition. Discussion around general securing the room, principles of ED care, establishing a relationship, managing anxiety regarding their visit
22:30-23:00: Brief Overview of Medications for Agitation
Brief focused comments on recommendation of medication for agitation in the school age population
23:00-35:00: Development and common diagnoses in School Age population
Common behavioral health diagnosis in the school age population (5-12yo) with a review of normal growth/development in the school age population leading to general approach to the population: activities for them and their family. This section also includes specific common diagnosis and medications typically used
Video 2 Index: Adolescent Behavioral Health Population:
0:00-8:30: General overview and approach
Scope of the adolescent behavioral health patient. Includes common growth and development, general approach to adolescents in the ED.
Discussion of common diagnosis in this patient population (Depression, Anxiety, oppositional defiant, conduct, bipolar disorders) and approaches to care in the ED.
Suicide in the adolescent population including screening and risk factors.
Video 3: Behavioral Patients: Coping and Common Triggers
This video reviews best tips for how to approach pediatric patients with behavioral health conditions
This video by Jen Schlesbusch focuses directly on pediatric patients within the emergency department presenting with a behavioral health crisis. Using this video (or portions of it) will aide in your discussions with the patient, safety while in your emergency department, and recommendations if they have become escalated.
Jen Schlesbusch is a member of the behavioral responses team in the emergency department at Boston Children's Hospital as a mileu counselor. She has worked at BCH for the last 15 years with experience with patients requiring inpatient psychiatric care but transitioned to the behavioral response team 7 years ago. She is also a Reiki practitioner focusing on meditation, coping skills, and breathing techniques bringing this knowledge to the hospital setting.
Video 3 Index:
Introduction to the speaker Jen Schlebusch and topic concept.
ABCs of behavior management. Understanding and responding effectively to problematic behavior. A: Antecedent, B: Behaviors and C: Consequences. This portion also goes through strategies to identify and define the behaviors of a patient.
0705-0940 Safety Issues
Review of specific issues with safety of patients, suggestions for increased safety for patients and healthcare workers. Consideration of type of monitoring type, room sweeps.
Considerations of triggering items for behavioral health patients with recommendation of decreasing these triggers which can help prevent escalations.
Non-medication strategies to decrease agitation while in the ED.
Consequences when behavioral is undesirable do’s and don’ts.
Language and communication recommendations for patients which can aide in interactions and behaviors.
Video 4: Bringing Psychiatric Inpatient Medication to your ED: Understanding, Starting, or Adjusting Therapy for Psychiatric Boarders
A video review of mediations to manage a pediatric patient in a behavioral health crisis.
This video by Dr. Qayyum will help in recommendation for initiation of pharmacological management medications while a pediatric patient is in behavioral crisis. This includes a discussion of the types of medications, case representations as well as recommendations for a pediatric patient with agitation or aggression.
Zheala Qayyum, MD, MMSc is the medical director of emergency psychiatric service at Boston Children's Hospital as well as the director of the adolescent psychology fellowship. She is faculty as Yale School of Medicine as well as Harvard Medical School.
Video 4 Index:
Introduction to the speaker as well as the topic with a focus on the increase in visits for behavioral health patients to the emergency department leading to increased initiation of medications while awaiting inpatient psychiatric care.
Starting points when considering interventions acutely in the emergency setting for behavioral health patients.
Non-pharmacologic management including clear communication, calming strategies and more.
Consideration for initial work up if consideration of starting medication or changing during their emergency department stay. Recommendations for medications that may need levels.
Case review of a patient presenting with psychotic symptoms. Including differential, considerations, medications commonly used.
Case review of patient presenting with manic symptoms. Including differential, considerations, medications commonly used.
Case review of patient presenting with anxious symptoms. Including differential, considerations, medications commonly used.
Major Depressive disorder initial medication recommendations.
Recommendation for medication to help with agitation while in the ED. Detailed description of medication use, dosage and side-effects for agitation.
Focused tips on medication use—what not to use together for example
Podcast: LGBTQ+ Behavioral Health Series
A podcast series discussing best practices for care of the LGBTQ+ youth in the Emergency Department
From establishing rapport and re-learning our introductions to gender-neutral physical exams and countering prior health care discrimination, this 3-part podcast series discusses how to affirm and care for LGBTQ+ youth in the Emergency Department. Join hosts Tom Balga (he/him) and Michael Goldman (he/him) with special guests Dax Sousa (he/him) and Kristen Campbell (she/they) as they discuss how we can do better for ALL our patients.
Part 1 Title : "A More Inclusive Introduction: Establishing Rapport with your LGBTQ+ Patients" (30 minutes)
Part 2: “The mental health burden of our LGBTQ+ patients Part 1” (15 minutes)
Part 3: “The mental health burden of our LGBTQ+ patients Part 2” (16 minutes)