Emergency medicine clinics of North America
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The care of patients with a psychiatric emergency is fraught with ethical challenges. Applying ethical reasoning to clinical challenges may help to improve care. ⋯ Maintaining patient confidentiality is a strong imperative for emergency physicians and should be protected unless compelling additional concerns take precedence. The goal of involuntary treatment should be to protect patients from harm that they would not be exposed to were they capable of autonomous decision making, not dangerous, or not impaired by their psychiatric illness using the least restrictive means possible.
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Psychiatric emergencies in pregnancy can be difficult to manage. The authors (both practicing psychiatrists and emergency clinicians) review the evaluation and treatment of common mental health diagnoses in pregnancy.
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Emerg. Med. Clin. North Am. · Nov 2015
ReviewSpecial Considerations in Pediatric Psychiatric Populations.
Proper treatment of the pediatric psychiatric population can be challenging. Emergency department (ED) boarding, availability of child and adolescent psychiatrists, lack of parental understanding, and inexperience working with children with special needs are just some of the obstacles the ED physician will encounter. We discuss the risk stratification and interventions necessary when dealing with children and adolescents presenting with suicidal ideation and violent behavior. In addition, we discuss the unique approaches to patients with autism spectrum disorders and attention deficit hyperactivity disorder.
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Emerg. Med. Clin. North Am. · Nov 2015
ReviewDown the Rabbit Hole: Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies.
Patients presenting with behavior or psychiatric complaints may have an underlying medical disorder causing or worsening their symptoms. Misdiagnosing a medical illness as psychiatric can lead to increased morbidity and mortality. ⋯ Certain patient populations and signs and symptoms have a higher association with organic causes of behavioral complaints. Many medical problems can present with or exacerbate psychiatric symptoms, and a thorough medical assessment is imperative.
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Emerg. Med. Clin. North Am. · Nov 2015
ReviewHealth Policy Considerations in Treating Mental and Behavioral Health Emergencies in the United States.
In recent years, health care providers have sounded the call that the US mental health system is in crisis. With decreases in funding and eroding access to care, the availability of psychiatric services has become increasingly limited, failing to meet growing needs. This article provides a brief history of mental health services in the United States and describes the current landscape of US psychiatric care; it touches upon some of the most important policy considerations, describing some of the glaring issues in US mental health care today. Last, it offers some potential remedies to improve care in acute behavioral emergencies.