Description

The field of emergency mental health care is evolving rapidly. In addition to continued widespread use of the traditional consultation model, in which psychiatrists provide on-call assistance to emergency department physicians, specialized psychiatric emergency services (PESs) are available in many cities, and newer models of integrated community psychiatric emergency care are being developed and implemented. With the spread of AIDS, the aging of the population, and the popularity of recreational substances of abuse, the scope and complexity of the field have increased as well. Emergency Psychiatry provides a snapshot of the current state of the art of this fast-paced discipline.

Readers of this volume will find • Survey of the major service models used in emergency psychiatry: the consultation model, the specialized PES model, and newer community models (crisis hospitalization, mobile teams, crisis residences)• Principles of triage of patients presenting to an emergency department with psychiatric problems, including a discussion of instruments used to assess psychosocial and cognitive functioning• Guidelines for assessing risk of suicide or violence• Standards for behavioral management of agitation and aggression aimed at reestablishing inner and outer controls for the patient in the least coercive manner• Discussion of legal and regulatory issues affecting emergency room practice• Guidance on application of psychotherapeutic technique to interviewing patients in crises so as to communicate concern, elicit cooperation and essential information about the patient’s state, and foster an alliance that facilitates appropriate treatment

Psychiatric emergencies can occur at any time and in any setting; for this reason, every mental health clinician should be familiar with the principles of crisis management and the cutting-edge issues surrounding the provision of emergency psychiatric care. Intended for psychiatrists, psychiatric and emergency medicine residents, and all mental health practitioners, this book offers an accessible guide to current practice and thought in this exciting field.

Description

Psychiatric emergencies are encountered throughout the practice of medicine, in many clinical settings. They may range from a patient expressing suicidal thoughts in an outpatient medical visit to an agitated, threatening patient with psychosis who is acutely intoxicated brought to the Emergency Department by ambulance. Decisions regarding admission, discharge, treatment, and referral are time-sensitive in the emergency setting or when acute safety issues are at stake. A broad knowledge of psychiatry and an understanding of potential medical etiologies of behavioral changes are important, as well as skills navigating what can be a complicated consultation relationship with the emergency department and challenging systems-based issues. In a time when emergency department visits continue to grow, resources for inpatient beds remain scarce and outpatient care can be difficult to access, the demand for psychiatric care and evaluation in the emergency setting is crucial.This volume, the 12th in the Primer On series, provides a straightforward approach to evaluating and managing common psychiatric emergencies. Blending case examples with up-to-date evidence-based approaches, this book serves as both a reference and introductory text for clinicians who are working in an emergency department or emergency consult setting.