ACADEMIC EMERGENCY MEDICINE • December 2001, Volume 8, Number 12 1187 SPECIAL CONTRIBUTIONS Mental Health Aspects of Emergency Medical Services for Children: Summary of a Consensus Conference LISA HOROWITZ,PHD, MPH, NANCY KASSAM-ADAMS,PHD, JACK BERGSTEIN, MD Abstract. Objective: To address the mental health needs of children involved in emergency medical ser- vices (EMS). Methods: A multidisciplinary consensus conference convened to identify mental health needs of children and their families related to pediatric medical emergencies, to examine the impact of psy- chological aspects of emergencies on recovery and sat- isfaction with care, and to delineate research ques- tions related to mental health aspects of medical emergencies involving children. Results: The consen- sus group found that psychological and behavioral factors affect physical as well as emotional recovery after medical emergencies. Children’s reactions are critically affected by age and developmental level, characteristics of the emergency medical event, and parent reactions. As frontline health care providers, EMS staff members are in a pivotal position to rec- ognize and effectively manage the mental health needs of patients and their families. Conclusions: Ecological changes in emergency departments, such as linkages to mental health follow-up services, train- ing of EMS providers and mental health profession- als, and focused research that provides an empirical basis for practice, are necessary components for im- proving current standards of health care. Key words: emergency services; mental health services; medical treatment (general). ACADEMIC EMERGENCY MEDICINE 2001; 8:1187–1196 T HE essential connection between physical and mental health is increasingly recognized in the health care arena (Institute of Medicine, 2001; U.S. Surgeon General, 1999). The interplay between psychological and emotional functioning and physical well-being is especially evident dur- ing pediatric medical emergencies and their after- math (Athey, O’Malley, Henderson, & Ball, 1997). Ill or injured children receiving emergency medical care may experience psychological distress with potentially serious consequences for their physical and mental health. Without proper attention to the mental health concerns of patients presenting with medical emergencies, optimal health care out- comes for children and their families can be com- promised. Nevertheless, in a busy emergency department (ED), psychological and behavioral symptoms often go unrecognized and untreated. From Children’s Hospital Boston (LH), Boston, MA; Children’s Hospital of Philadelphia (NKA), Philadelphia, PA; and West Virginia University Hospitals and Jon Michael Moore Trauma Center (JB), Morgantown, WV. Received March 21, 2001; accepted March 27, 2001. Address for correspondence and reprints: Nancy Kassam-Ad- ams, TraumaLink, 3535 10th Floor, Children’s Hospital of Phil- adelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104. E-mail: nlkaphd@mail.med.upenn.edu 2001 Society of Pediatric Psychology. A related commentary appears on page 1182. Formal mental health services for children are available in only a small minority of EDs (U.S. Consumer Product Safety Commission, 1997). Serving as frontline providers, emergency medical services (EMS) staff members are in a pivotal po- sition to intervene to mitigate negative psycholog- ical sequelae. All multidisciplinary staff involved in pediatric emergency care and transport (includ- ing physicians, nurses, psychologists, social work- ers, emergency medical technicians, and others) have a potential role to play in addressing the emo- tional needs of children. This article presents a summary of a national consensus conference on the mental health needs of children involved in emergency medical services, convened by the American Psychological Associa- tion (APA) under the auspices of the Emergency Medical Services for Children (EMSC). The confer- ence brought together expert clinicians and re- searchers representing most of the major disci- plines involved in children’s emergency medical services practice and research, including emer- gency physicians, emergency nurses, paramedics and emergency medical technicians (EMTs), pedi- atricians, trauma surgeons, pediatric and child clinical psychologists, child psychiatrists, and so- cial workers. The charge to this consensus group was to identify the scope of mental health needs of