Emergency Psychiatry

A recent experience on street rounds offered a moment that brought this psychiatrist back to one of the main reasons she chose psychiatry as a profession.

Which patients are at greatest risk for premature death following discharge?

In some segments of the evolving health care system, primary health care teams with psychiatry at their core are becoming a reality. Here are 6 ways psychiatrists add value to primary care health teams.

Here: a review of issues related to assessment of patients for suicide risk in the ED -- and an overview of emerging approaches and research that one day will lead to more reliable assessment and interventions based more on science than on art or luck.

Medical, psychiatric, and/or developmental disorders can be falsified in a variety of ways. Know the warning signs often missed by clinicians.

Suicide is now the second leading cause of death among college students. But only 60% of colleges and universities have a psychiatrist on staff.

The current shortage of psychiatric beds in the US is a major problem. Patients are discharged prematurely and often have to be readmitted or end up homeless or incarcerated.

Gun violence by alienated, disgruntled individuals isn't new. So what changes may help account for our recent spate of mass shootings?

How targeted interventions may reduce the burden of premature mortality among patients with schizophrenia and other psychiatric disorders.

This issue of Psychiatric Times covered government fraud, emergency psychiatry, PTSD in practicing psychiatrists, college mental health, and other critical issues.

Nearly half of children who present to emergency departments with self-harm receive no mental health assessment. What are the essential elements needed to interview children and adolescents in the context of a psychiatric emergency?

Jails have a much higher percentage of homeless mentally ill than does the general community, and those with psychiatric disorders (eg, schizophrenia) must often fend for themselves. Here are some solutions.

Currently, 1 in 15 youths undergoing psychiatric evaluation in the emergency department is restrained. This article covers diagnostic and therapeutic interventions that can reduce fear and put the young patient on a path to recovery.

It is important to recognize and document the abilities and deficits of a patient in order to determine capacity.

Acute intoxication is the most likely culprit for an increased risk of violence or agitation, but personality, psychosis, and cognitive problems can all play a role. A skilled clinician can glean a great deal of information in a short period of time.

There is an impressive array of presentations and speakers at an upcoming meeting, the only one in the country to address behavioral emergencies in the acute care setting.

There has probably never been a worse place and worse time to have a severe mental illness than now in the United States. How did we get into this mess?

Good documentation can be used by psychiatrists to enhance the physician-patient relationship. Of course, transparency could come at a price to practitioners, so following reasonable guidelines outlined in this article is key.

Many years ago, the model approach to mental health treatment was the therapeutic community: "As Aristotle noted long ago, man is a social animal and only in a social unit can he experience a whole life." More in this blog.

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.