Adolescent Consultation Services

ACS Annual Event 2011 - Kids in Crisis: Psychiatric Emergencies in the Juvenile Court

November 17, 2011

"The importance of what we do today really does implicate generations to come." --Dr. Debra Pinals, Department of Mental Health Medical Director

Kids in Crisis: Psychiatric Emergencies in the Juvenile Court was the topic of the ACS November 17th Event. Friends of ACS, donors to the program, and colleagues in the field joined us at the historic Union Club of Boston to learn about ACS' services for kids in crisis.

Welcoming a Diverse Audience

Lia Poorvu, ACS Board President, welcomed the widely diverse audience, noting that this diversity demonstrates the complexity of ACS's work. Board member, William Paine, observed that "without ACS, there would be a lot of kids who aren't getting the services they need."

Gail Garinger, first Child Advocate for Massachusetts, moderated. She noted the importance of the Juvenile Court Clinics, as they integrate with all other services.

Dr. Jill Durand talked about three kids in crisis, noting that ACS clinicians are called in when a child verbalizes suicidal threats or behaves in an alarming way that requires immediate attention. The interface between the child's needs and the court process makes these evaluations particularly specialized and difficult to perform.

Kids in Crisis: a Systems Perspective

Dr. Michael Jellinek noted that clinicians enter these crisis situations in a child's "moment of desperation." He asked the audience to imagine being a child facing "all those adults in court" -- the child's unbelievable vulnerability leads to many psychiatric emergencies.

Dr. Jellinek suggested that systematic, early screening by pediatricians could identify kids early as high-risk for a psychiatric condition. Services could then be coordinated and the right treatment provided. Ideally, this would prevent potential emergencies before they occur.

He also recommended that a common tool such as, the Child Global Assessment Scale, be used across state agencies to assess the child's functioning. Such a scale would provide the basis for a standardized and reliable way of communicating the needs of youth in crisis.

Sad and Often Tragic Stories

Dr. Debra Pinals emphasized the reality of the sad, and often tragic, emergency situations, as well as the depth of knowledge required by the Juvenile Court Clinicians who deal with them. She said that Massachusetts excels above all other states in providing Juvenile Court Clinic services to youth and noted that "the importance of what we do today really does implicate generations to come."

"For these are all our Children"

Rebecca Pries concluded saying, "ACS could not do this difficult work without the support of the people in this room." She invited the audience to visit ACS at our clinic sites, or on our website, where they will be welcomed by the James Baldwin quote: "For these are all our children," a hallmark of our commitment to treat court-involved children as we would our own.