Emergency Psychiatry: How Far Have We Come?

Abstract

The practice of emergency psychiatry is complex, rich, and rewarding. Emergency psychiatry provides a unique opportunity to experience cases related to novel drugs of abuse and to identify maltreatment, domestic/intimate partner violence, and even human trafficking. The general principles of psychiatric emergency practice include flexible evaluation styles in terms of setting and duration of encounters, targeted prescribing, and readiness for interactions with other specialties, law enforcement, and community mental health providers. The specific needs of the emergency department (ED) patient population, especially related to social context and substance use, need to be taken into account for a successful practice. Two populations/presentations of particular relevance in the ED are patients with contingent suicidality and those with repeat visits/high resource use. High burnout rates secondary to prevalent agitation, unpredictable presentations, and even violence, are endemic to emergency psychiatry practice and need to be carefully managed. [ Psychiatr Ann. 2018;48(1):63–68.]