When I think back to my training in pediatrics and emergency medicine, I realize how little of it truly prepared me to address mental health crises in children and teens. Like many of my peers, I was trained to manage trauma, resuscitations, and acute medical conditions.
But when it came to a child expressing suicidal thoughts, I often felt under-equipped and unsure. During my fellowship at Monroe Carell Children’s Hospital at Vanderbilt, especially throughout the COVID-19 pandemic, I began learning crisis assessment skills in real time — on the job — while struggling to reconcile my discomfort with the urgency of the needs I was seeing every day.
That changed when I joined the Preventing Youth Suicide (PYS) Collaborative, sponsored by Cardinal Health Foundation and Children’s Hospital Association. I was drawn to the group because of my role in process improvement and my familiarity with the inner workings of the pediatric emergency department.
"This work matters. It has changed how I practice medicine. And most importantly, it has helped me be part of something that gives young people - and their families -- hope for a safer, more supported future."
What I found was a community committed to real, meaningful change — one that taught me how to apply evidence-based tools for assessing suicide risk and reshaped how I thought about my role in mental health care.
As part of the collaborative, I participated in redesigning my hospital’s approach to crisis assessments. Our team integrated structured tools, emphasized collaborative safety planning, and ensured we were counseling families effectively about lethal means — especially firearms and medications. These practices moved suicide prevention from an abstract, uncomfortable topic to something I could approach with confidence, clarity, and compassion.
One patient in particular stands out. A teenage boy came to our emergency department for suicidal ideation. He didn’t have a plan, and through a thoughtful, evidence-informed discussion, his family ultimately felt comfortable pursuing intensive outpatient therapy.
During our conversation, I asked about the home environment — what could be made safer, how we could support a smooth transition. That’s when the parents paused and acknowledged they had unsecured firearms in the home. Together, we walked through steps they could take to lock up or remove potentially dangerous items. It was a moment of honesty and shared purpose that may well have saved his life.
Before joining the PYS Collaborative, I might not have asked those questions. I might have deferred the conversation to someone else, assuming mental health safety planning was outside my expertise. But now, I see how central this work is to what we do in pediatric emergency medicine. My involvement in this collaborative didn’t just give me tools — it gave me ownership. It gave me a framework to support patients and families through some of their hardest moments, and the confidence to meet them there with skill and heart.
This work matters. It has changed how I practice medicine. And most importantly, it has helped me be part of something that gives young people — and their families — hope for a safer, more supported future.
