Big Book Of Emergency Department Psychiatry

This book focuses on the operational and clinical strategies needed to improve care of Emergency Psychiatric patients. Boarding of psychiatric patients in ED’s is recognized as a national crisis. The American College of Emergency Physicians identified strategies to decrease boarding of psychiatric patients as one of their top strategic goals. Currently, there are books on clinical care of psychiatric patients, but this is the first book that looks at both the clinical and operational aspects of caring for these patients in ED setting. This book discusses Lean methodology, the impact of long stay patients using queuing methodology, clinical guidelines and active treatment of psychiatric patients in the ED.

Many hospital emergency departments are overcrowded and short-staffed, with a limited number of available hospital beds. It is increasingly hard for emergency departments and their staff to provide the necessary level of care for medical patients. Caring for people with psychiatric disabilities raises different issues and calls on different skills. In Emergency Department Treatment of the Psychiatric Patient, Dr. Stefan uses research, surveys, and statutory and litigation materials to examine problems with emergency department care for clients with psychiatric disorders. She relies on interviews with emergency department nurses, doctors and psychiatrists, as well as surveys of people with psychiatric disabilities to present the perspectives of both the individuals seeking treatment, and those providing it. This eye-opening book explores the structural pressures on emergency departments and identifies the burdens and conflicts that undermine their efforts to provide compassionate care to people in psychiatric crisis. In addition to presenting a new analysis of the source of these problems, Dr. Stefan also suggests an array of alternatives to emergency department treatment for people in psychiatric crisis. Moreover, the author proposes standards for treatment of these individuals when they do inevitably end up in a hospital emergency department. Emergency Department Treatment of the Psychiatric Patient presents a thoughtful and thorough analysis of the difficulties faced by people with psychiatric disabilities when seeking emergency medical care. It is essential reading for anyone working in a hospital emergency department, as well as health care policy makers, and advocates and lawyers for people with psychiatric disabilities.

Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk and make disposition decisions in a fast-paced and potentially chaotic setting. Patients may be medically ill, agitated, intoxicated, or suicidal, and resources for treatment may be difficult to access. A Case-Based Approach to Emergency Psychiatry provides the emergency department clinician with vivid and complex cases, discussed by psychiatrists who work daily in the emergency setting, that illustrate basic principles of assessment, diagnosis and treatment. These challenging and complex cases are based on the years of experience of the authors combined with current evidence-based practices and discussion. Risk assessment, psychosis, mood disorder, substance abuse, ethics, forensic issues, and personality disorders are discussed, along with child and adolescent, geriatric, and developmental disabilities. Special attention is also paid to alternatives to inpatient care, short-term crisis intervention, and the interface between medical and psychiatric illnesses. The case-based format allows the authors to link aspects of the clinical presentation to discussion and literature review in a memorable and compelling format.

The second edition of Clinical Manual of Emergency Psychiatry is designed to help medical students, residents, and clinical faculty chart an appropriate course of treatment in a setting where an incorrect assessment can have life-or-death implications. Arranged by chief complaint rather than by psychiatric diagnosis, each chapter combines the fresh insights of an accomplished psychiatry trainee with the more seasoned viewpoint of a senior practitioner in the field, providing a richly integrated perspective on the challenges and rewards of caring for patients in the psychiatric emergency department. This newly revised edition presents current approaches to evaluation, treatment, and management of patients in crisis, including up-to-date guidelines on use of pharmacotherapy in the emergency setting; suicide risk assessment; evaluation of patients with abnormal mood, psychosis, acute anxiety, agitation, cognitive impairment, and/or substance-related emergencies; and care of children and adolescents. The editors have created an accessible text with many useful features: A chapter devoted to effective strategies for teaching, mentoring, and supervision of trainees in the psychiatry emergency service. Chapters focused on assessment of risk for violence in patients, determination of the need for seclusion or restraint, and navigation of the legal and ethical issues that arise in the emergency setting. Clinical vignettes that contextualize the information provided, allowing readers to envision applicable clinical scenarios and thereby internalize important concepts more quickly Constructive "take-home" points at the end of each chapter that summarize key information and caution against common clinical errors. References and suggested readings to help readers pursue a deeper understanding of concepts and repair any gaps in knowledge. Emergency psychiatry is one of the most stressful and challenging areas of practice for the psychiatric clinician. The guidelines and strategies outlined in Clinical Manual of Emergency Psychiatry, Second Edition, will help psychiatric trainees and educators alike to make sense of the complex clinical situations they encounter and guide them to advance their skills as clinicians and educators.

The field of emergency psychiatry is complex and varied, encompassing elements of general medicine, emergency medicine, trauma, acute care, the legal system, politics and bureaucracy, mental illness, substance abuse and addiction, current social issues, and more. In one comprehensive, highly regarded volume, Emergency Psychiatry: Principles and Practice brings together key principles from psychiatric subspecialties as well as from emergency medicine, psychology, law, medical ethics, and public health policy. Leading emergency psychiatrists write from their extensive clinical experience, providing evidence-based information, expert opinions, American Psychiatric Association guidelines, and case studies throughout the text. This fully up-to-date second edition covers all of the important issues facing psychiatry residents and practitioners working in today’s emergency settings, or who encounter psychiatric emergencies in other medical settings.

This comprehensive, go-to volume features cutting edge discussion of the emergency department management of mental health patients.

This fully updated second edition focuses on mental illness, both globally and in terms of specific mental-health-related visits encountered in emergency department settings, and provides practical input from physicians experienced with adult emergency psychiatric patients. It covers the pre-hospital setting and advising on evidence-based practice; from collaborating with psychiatric colleagues to establishing a psychiatric service in your emergency department. Potential dilemmas when treating pregnant, geriatric or homeless patients with mental illness are discussed in detail, along with the more challenging behavioral diagnoses such as substance abuse, factitious and personality disorders, delirium, dementia, and PTSD. The new edition of Behavioral Emergencies for Healthcare Providers will be an invaluable resource for psychiatrists, psychologists, psychiatric and emergency department nurses, trainee and experienced emergency physicians, and other mental health workers.

One of the cardinal facets of the delivery of mental healthcare is the attention given to emergency conditions-which is the focus of this book. The manifestations of psychiatric emergencies in low- and middle-income countries may be coloured by many factors, such as culture, the social context and religious belief systems. Hence, there is a need to not only understand these, but also formulate logical and acceptable forms of intervention. This book attempts to give the reader an overview of the kinds of psychiatric emergencies that can occur and the strategies employed to manage these in developing countries. The chapters on anxiety disorders, psychotic disorders, personality disorders and substance abuse disorders describe the presentation and management of these disorders in the emergency setting. The book deals with special population groups, such as women, children and the elderly, who require different modes of intervention. The next group of chapters addresses emergencies following psychosocial and environmental events. Among the aspects covered are grief, suicidal behaviour and psychiatric emergencies following disasters. These chapters have a special significance, considering the rising rate of suicide and increase in the frequency of disasters in developing countries. The chapters on suicidal and uncooperative patients dwell on particularly challenging clinical situations, emphasizing ethical issues and the need to ensure the safety of the patient. A discussion of the medicolegal aspects of a psychiatric emergency in developing countries is of relevance since many countries still follow outdated and archaic legal procedures. As patients often present to the emergency department both with psychiatric as well as physical symptoms, a few chapters are devoted to psychiatric emergencies associated with medical disorders, sexual disorders and drug-related issues. This book aims to meet the needs of physicians, researchers and all emergency care personnel dealing with those in a state of emotional crisis. It should serve to help all types of mental health professionals in developing countries to effectively and appropriately manage the various kinds of psychiatric emergencies.