Emergency Psychiatry

In the US, suicide is a leading cause of death, ranking third among youths aged 15 to 24. Rates of suicide attempts and death are highest among US Pacific Island indigenous youths. Emergency departments play a key role in suicide prevention, especially in this and other minority populations.

A video summarizing key points of a presentation titled “Agitation and Aggression: Managing the Acute Episode and Beyond, An Evidence-Based Approach.”

Agitation is a spectrum of symptoms . . . it can go all the way from being irritable up to pacing to lashing out to clenched fists to outright violence. Intervention via de-escalation techniques at an early stage is optimal. More in this podcast.

Emergency psychiatry is helping to redefine acute mental health treatment-facilitating timely access, in less restrictive, outpatient levels of care, for patients in crisis.

In the eyes of many, the current societal approach to the treatment of psychiatric disorders cannot possibly be considered humane. More in this commentary.

Psychiatrists are urged to familiarize themselves with these new drugs and the typical presentations of patients who use them since implications of misdiagnosis can be far-reaching.

Ideology is much less important than common sense solutions. The mentally ill have many unmet needs and suffer from great and undeserved coercion.

Emergency departments are often forced to hold patients who are acutely dangerous to themselves or others for long periods until an inpatient bed can be obtained.

This article highlights several features of medical and social importance that are somewhat unique to the Somali refugee community in the US.

A resident describes her experience in dealing with a potentially agitated patient.

A therapeutic alliance can serve to build a trusting relationship between clinician and patient and increase the patient’s feelings of agency and autonomy.

For now, it is encouraging to know that psychiatrists remember that they, too, are physicians first who can tap into their medical training to provide comprehensive patient care.

The rise in suicides and lethal overdoses of opioid analgesics is probably not coincidental. In most overdose deaths, we have no way of knowing with any degree of certainty whether they were accidental deaths or intentional suicides.

Both clinicians and weather forecasters employ the same general process of information gathering, analysis, and reaching a conclusion.

Perceived relationship power helps to explain the association between intimate partner violence and mental health issues.

Newtown’s loss has finally forced us to look more deeply at violence and the treatment of mental health within our society.

Mental health professionals, state-run forensic services, and law enforcement agencies need to come together and discuss the most efficient and safe models when confronting psychiatric emergencies to improve and expand these practices across America.

"You turn on the television, and violence is there. You go to a movie, and violence is there."

Several studies have been undertaken to test the efficacy of drugs in the management of aggression and hostility in patients with schizophrenia and other mood disorders.

Agitation can be displayed in patients as loud, disruptive, hostile, sarcastic, threatening, hyperactive, and/or combative. Here are tips on managing agitated patients.

Agitated patients who display “excessive verbal and/or motor behavior”-can be loud, disruptive, hostile, sarcastic, threatening, hyperactive, and even combative. This article discusses new best practices and guidelines for agitation.

He wasn’t the first person I met days before I was to start my psychiatric residency, but as I walked about in my new city, he caught my attention much more than most. As psychiatrists, we typically assume that we will hear the inside stories, even if in bits and pieces, that will help us better understand and help patients. But perhaps we are too expectant . . .

Here we present how to assess safely patients who become oppositional or menacing in a clinic or office.

Here we address some of these problems of meaningless phrasing, empty shells, and template-distorted recording in an attempt to improve clinical documentation for both clinical care and risk management.

Every case of patient violence against clinicians provides lessons to be learned in safety management. Here: some key points that can enhance physician safety and help minimize the risks.

The psychiatric emergency room (ER) is an intense, stressful work environment where psychiatrists must perform rapid assessments and make swift treatment decisions.

A shortage of inpatient beds and staff at mental health facilities may mean that a patient presenting to an emergency department may be there for an extended period of time.

Violence by patients towards staff members is an inherently complex matter for the physically and/or psychologically injured person. An expert in the field of forensic psychiatry answers a reader's question about what clinicians can do in the aftermath of an assault.

Which treatment was found to be detrimental to patients with PTSD? What is the Brøset Violence Checklist used for? These questions and more in this week's quiz.

It is not surprising that one of the most complicated aspects of collaboration with faculty and staff in the ED setting is the professional or social contract.