Abstract
ConsultAdo is an outpatient crisis intervention service for adolescents aged 12 to 18 years presenting with acute suicidal crises, including suicidal ideation and recent suicide attempts associated with abrupt psychosocial and emotional destabilization. The service was developed within an initiative aimed at improving regional mental health care provision and reducing emergency department utilization for acute psychiatric crises. It is embedded in a Sector III child and adolescent psychiatry service (Guidance Infantile) in Toulouse, France.
The service receives referrals primarily from child and adult psychiatric emergency departments, enabling rapid access to care without systematic hospitalization.
The intervention model is based on a brief and intensive outpatient follow-up delivered by a minimal multidisciplinary team composed of an advanced practice nurse (full-time), a clinical psychologist (0.5 FTE), a child and adolescent psychiatrist (0.3 FTE), and a care coordinator. The caseload is limited to 15 active patients to ensure clinical intensity and continuity of care.
Care includes repeated clinical risk assessment using a standardized framework (RUD), structured safety planning, and digital support tools (“Hop ma liste”). Patients receive 1 to 3 clinical contacts per week depending on severity, with active family involvement and systemic interventions when indicated.
The model integrates coordination with community stakeholders including child protection services, schools, general practitioners, and outpatient mental health services. A planned transition to community care is organized at discharge.
Preliminary observations suggest reduced emergency department reattendance and very low treatment dropout rates, supporting sustained outpatient clinical containment during acute suicidal crises.
