Crisis Interventions for Children and Adolescents with Depression and Suicidality: A Systematic Review and Meta-Analysis.
Cristina Díaz-Téllez, Inmaculada Peñuelas-Calvo, Adrián Alacreu-Crespo et al.
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In 30 seconds
This systematic review and meta-analysis examined crisis services for children and adolescents experiencing acute mental health crises, including severe depression, suicidal ideation, self-harm, and suicidal behaviour. It included 15 studies evaluating 15 interventions. Four brief, structured interventions targeting suicidal ideation and self-harm reported reductions in suicidal thoughts, suicide attempts, and emergency department visits; family-focused approaches were associated with improved family functioning and fewer hospitalisations. Overall, crisis services may offer a promising alternative to hospitalisation, but the evidence is heterogeneous and largely observational, so causal conclusions cannot be drawn.
Key findings
- Four interventions targeting suicidal ideation and self-harm reported reductions in suicidal thoughts, suicide attempts, and emergency department visits.
- Seven family-focused interventions, evaluated in eight studies, improved communication and family cohesion and reduced hospitalisation rates.
- Three crisis-stabilisation and community-linkage interventions improved continuity of care and decreased emergency service utilisation.
- One residential intervention, evaluated in two studies, had mixed findings: some behavioural improvements but limited effects on internalising symptoms.
Why it matters
Acute crises in young people can involve substantial suicide risk and may lead to hospitalisation. The reviewed services offer intensive support in the young person’s natural environment and often involve family members. The findings suggest potential benefits across symptoms, service use, and family functioning, while underscoring that the current evidence is not strong enough to establish which models work best.
What to keep in mind
The evidence base is limited, largely observational, and heterogeneous; causal conclusions cannot be drawn. The review also identifies a need for direct comparisons between service models and long-term follow-up.