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Early on, psychiatry accepted the idea that unconscious psychology affected the body to cause disease. By the 1970s, the rise of psychiatric drugs pushed the field in a biological direction, and by the 1980s, psychoanalysis was in full retreat, at least in the halls of psychiatric power. S. Nassir Ghaemi, MD, adds to the debate.

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As hospital-based psychiatric emergency programs around the country demonstrate the ability to minimize ED boarding, provide cost-savings, and improve patient outcomes and clinician satisfaction, the challenge will be how to keep these models of psychiatric care self-supporting.