Management of mental health crises among youths with and without ASD: A national survey of child psychiatrists

Objective: This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). Methods: A customonlinemental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis. Child psychiatrists reporting on management of youths with ASD (N=492) and without ASD (N=374) completed the survey. Results: About 75% of psychiatrists in both groups were willing to accept a child with a history of a mental health crisis in their practice. During a crisis, psychiatrists caring for youths with ASD had less access to external consultation resources, such as a crisis evaluation center or other mental health professionals, compared with those caring for youths without ASD. Psychiatrists also expressed concerns about the ability of emergency department professionals and emergency responders to managemental health crises among youths in a safe and developmentally appropriate manner, particularly among those with ASD. Conclusions: Child psychiatrists are in need of more external resources to manage youths with ASD who are experiencing a mental health crisis. There is also a need to develop best practice procedures for emergency responders who are working with youths experiencing a mental health crisis.