Models Of Emergency Psychiatric Services That Work

This book describes a spectrum of possible solutions to providing comprehensive emergency psychiatric care. It discusses in detail all components of emergency psychiatric care, such as triage, security, management of suicide risk, violent patients, interdisciplinary treatment teams, administration, and telepsychiatry. It has been written by and is of interest to psychiatrists, emergency medicine physicians, nurses, social workers, administrators, the police and security staff.

Originally published in 1986, this volume presents the clinical and administrative aspects of emergency psychiatry from the point of view of the clinician administrator involved in organizing and running an emergency service. Part 1 provides an administrative overview of psychiatric emergency care – the development of the field, the concepts, the patient profile, the team, the architecture, fiscal planning, legal constraints as well as training and research issues. Part 2 describes psychiatric emergency care delivery systems in the emergency department, the average hospital wards, the community mental health centers and health maintenance organizations. Part 3 gives examples of the process of administration – in one instance how a psychiatric emergency service developed, in the other how one functions day to day and what themes recur administratively. Part 4 focuses on protocols and models useful to the emergency service administrator: protocols, records, standards of care, politics, liaison with the court, mobile response, collaborative arrangements and disaster preparedness. Part 5 provides an annotated bibliography which reviews and draws attention to the relevant literature for the clinicians and administrators to use in practicing emergency psychiatry.

Written and edited by leading emergency psychiatrists, this is the first comprehensive text devoted to emergency psychiatry. The book blends the authors' clinical experience with evidence-based information, expert opinions, and American Psychiatric Association guidelines for emergency psychiatry. Case studies are used throughout to reinforce key clinical points. This text brings together relevant principles from many psychiatric subspecialties—community, consultation/liaison, psychotherapy, substance abuse, psychopharmacology, disaster, child, geriatric, administrative, forensic—as well as from emergency medicine, psychology, law, medical ethics, and public health policy. The emerging field of disaster psychiatry is also addressed. A companion Website offers instant access to the fully searchable text. (www.glickemergencypsychiatry.com)

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.

Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.

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 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.

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.