psychiatric emergency services


Summary: Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.

Top Publications

  1. Chaput Y, Lebel M. Demographic and clinical profiles of patients who make multiple visits to psychiatric emergency services. Psychiatr Serv. 2007;58:335-41 pubmed
    ..Most visits to the psychiatric emergency service were made by frequent users who had distinctive profiles, which are potentially useful for developing clinical strategies to reduce the impact of this patient group on this service. ..
  2. Marco C, Vaughan J. Emergency management of agitation in schizophrenia. Am J Emerg Med. 2005;23:767-76 pubmed
    ..Psychiatric consultation should be sought for patients with schizophrenia and uncertain disposition determinations, or those requiring other complex management decisions. ..
  3. Pasic J, Russo J, Roy Byrne P. High utilizers of psychiatric emergency services. Psychiatr Serv. 2005;56:678-84 pubmed
    ..of this study was to examine the sociodemographic and clinical characteristics of high utilizers of psychiatric emergency services. Data were collected over four years for 761 patients who were identified as high utilizers according ..
  4. Hazlett S, McCarthy M, Londner M, Onyike C. Epidemiology of adult psychiatric visits to US emergency departments. Acad Emerg Med. 2004;11:193-5 pubmed
    ..Patient characteristics influence the likelihood of a PREDV. Further research is needed to better understand the role that hospital EDs play in the delivery of health care services to those with mental illness. ..
  5. van Ommeren M, Saxena S, Saraceno B. Mental and social health during and after acute emergencies: emerging consensus?. Bull World Health Organ. 2005;83:71-5; discussion 75-6 pubmed
    ..This affirmation of emerging agreement is important and should give clear messages to health planners. ..
  6. Perez Rodriguez M, Baca Garcia E, Quintero Gutierrez F, Gonzalez G, Saiz Gonzalez D, Botillo C, et al. Demand for psychiatric emergency services and immigration. Findings in a Spanish hospital during the year 2003. Eur J Public Health. 2006;16:383-7 pubmed
    ..They did not consult because of psychoses or affective disorders, but mainly because of reactive conditions related to the stress of migration. ..
  7. Chaput Y, Lebel M, Labonté E, Beaulieu L, Paradis M. Pathological gambling and the psychiatric emergency service. Can J Psychiatry. 2007;52:535-8 pubmed
    ..They were, however, significantly less likely to be frequent users of the PES or to be hospitalized. Although still manageable, the clinical impact of PG on the PES increased significantly during the course of this study. ..
  8. Pascual J, Malagón A, Arcega J, Gines J, Navinés R, Gurrea A, et al. Utilization of psychiatric emergency services by homeless persons in Spain. Gen Hosp Psychiatry. 2008;30:14-9 pubmed publisher
    Studies examining the relationship between homeless persons and the use of psychiatric emergency services (PES) in a country with universal access to health care are lacking...
  9. Claassen C, Michael Kashner T, Gilfillan S, Larkin G, John Rush A. Psychiatric emergency service use after implementation of managed care in a public mental health system. Psychiatr Serv. 2005;56:691-8 pubmed
    ..whether implementation of managed care in a public mental health system affected return visits to psychiatric emergency services within 180 days of an index visit...

More Information


  1. Brown J. Psychiatric emergency services: a review of the literature and a proposed research agenda. Psychiatr Q. 2005;76:139-65 pubmed
    To gain a better understanding of the scope of previous research on psychiatric emergency services (PES) and to identify areas of focus for future studies, the author reviews PES literature published between 1983 and 2003...
  2. Pascual J, Oller S, Soler J, Barrachina J, Alvarez E, Perez V. Ziprasidone in the acute treatment of borderline personality disorder in psychiatric emergency services. J Clin Psychiatry. 2004;65:1281-2 pubmed
  3. Baca Garcia E, Diaz Sastre C, Resa E, Blasco H, Conesa D, Saiz Ruiz J, et al. Variables associated with hospitalization decisions by emergency psychiatrists after a patient's suicide attempt. Psychiatr Serv. 2004;55:792-7 pubmed
  4. Allen M, Currier G. Use of restraints and pharmacotherapy in academic psychiatric emergency services. Gen Hosp Psychiatry. 2004;26:42-9 pubmed
    b>Psychiatric emergency services (PES) are an increasingly important component of mental health services...
  5. Lee T, Renaud E, Hills O. Emergency psychiatry: an emergency treatment hub-and-spoke model for psychiatric emergency services. Psychiatr Serv. 2003;54:1590-1, 1594 pubmed
  6. Dhossche D, Ghani S. Diagnostic stability of schizophrenia in psychiatric emergency room patients. Ann Clin Psychiatry. 1998;10:151-5 pubmed
    ..Further studies are needed in other settings to assess if underdiagnosis is associated with undertreatment of schizophrenia in females. ..
  7. Catalano R, McConnell W, Forster P, McFarland B, Thornton D. Psychiatric emergency services and the system of care. Psychiatr Serv. 2003;54:351-5 pubmed
    Admissions to psychiatric emergency services have frequently been cited as a gauge of how well a mental health system manages behavioral disorders...
  8. Gjelstad K, Løvdahl H, Ruud T, Friis S. [Compulsory admissions for observation in emergency psychiatric departments--discharge next day?]. Tidsskr Nor Laegeforen. 2003;123:917-20 pubmed
  9. Arfken C, Zeman L, Yeager L, Mischel E, Amirsadri A. Frequent visitors to psychiatric emergency services: staff attitudes and temporal patterns. J Behav Health Serv Res. 2002;29:490-6 pubmed
    Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors...
  10. Huf G, da Silva Freire Coutinho E, Fagundes H, Oliveira E, Lopez J, Gewandszajder M, et al. Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study. BMC Psychiatry. 2002;2:4 pubmed
    ..In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary...
  11. George L, Durbin J, Sheldon T, Goering P. Patient and contextual factors related to the decision to hospitalize patients from emergency psychiatric services. Psychiatr Serv. 2002;53:1586-91 pubmed
    ..Patients with the most need are being admitted to inpatient units despite significant systemic pressures on inpatient services. The SPI is a useful and discriminating tool for evaluating clinical practice in emergency services. ..
  12. Currier G, Allen M. Organization and function of academic psychiatric emergency services. Gen Hosp Psychiatry. 2003;25:124-9 pubmed
    b>Psychiatric emergency services (PES) are evolving as freestanding, parallel components of emergency departments at many tertiary care medical centers in the U.S...
  13. Wingerson D, Russo J, Ries R, Dagadakis C, Roy Byrne P. Use of psychiatric emergency services and enrollment status in a public managed mental health care plan. Psychiatr Serv. 2001;52:1494-501 pubmed
    ..Problematic behavior and history of hospitalization were the best predictors of enrollment status. ..
  14. Yildiz A, Sachs G, Turgay A. Pharmacological management of agitation in emergency settings. Emerg Med J. 2003;20:339-46 pubmed
    ..An oral treatment should always be offered first for building up an alliance with the patient and suggesting an internal rather than external locus of control. ..
  15. Way B, Banks S. Clinical factors related to admission and release decisions in psychiatric emergency services. Psychiatr Serv. 2001;52:214-8 pubmed was to identify important clinical variables that influence admission and release decisions in psychiatric emergency services. Physicians at four urban psychiatric emergency services rated 465 patients on ten clinical dimensions,..
  16. Wand T, Schaecken P. Consumer evaluation of a mental health liaison nurse service in the Emergency Department. Contemp Nurse. 2006;21:14-21 pubmed
    ..Quantitative and qualitative data generated from the study are presented and discussed. The authors share their observations and experiences in conducting the study in order to further develop this avenue of service evaluation. ..
  17. Villari V, Rocca P, Fonzo V, Montemagni C, Pandullo P, Bogetto F. Oral risperidone, olanzapine and quetiapine versus haloperidol in psychotic agitation. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:405-13 pubmed
    ..Our results show that in the clinical practice setting of emergency psychiatry olanzapine, risperidone, quetiapine are as effective as haloperidol and better tolerated. ..
  18. Chamberlain K. The Gadarene Demoniac finds wholeness. J Pastoral Care Counsel. 2007;61:133-4 pubmed
  19. Flannery R. Precipitants to psychiatric patient assaults: review of findings, 2004-2006, with implications for EMS and other health care providers. Int J Emerg Ment Health. 2007;9:5-11 pubmed
    ..The implications of these findings and specific strategies to reduce these precipitant risks for EMS and other health care providers are presented. ..
  20. Ruggeri M, Salvi G, Perwanger V, Phelan M, Pellegrini N, Parabiaghi A. Satisfaction with community and hospital-based emergency services amongst severely mentally ill service users: a comparison study in South-Verona and South-London. Soc Psychiatry Psychiatr Epidemiol. 2006;41:302-9 pubmed
    ..A measurement of the satisfaction with psychiatric emergency services was conducted among all those users in the two catchment areas who, in a 1-year period: (1) had at ..
  21. McDonough S, Wynaden D, Finn M, McGowan S, Chapman R, Hood S. Emergency department mental health triage consultancy service: an evaluation of the first year of the service. Accid Emerg Nurs. 2004;12:31-8 pubmed
    ..The review provided evidence regarding the value of the emergency mental health triage and consultancy service and highlighted the advanced practice role undertaken by mental health nurses in this position. ..
  22. Muroff J, Jackson J, Mowbray C, Himle J. The influence of gender, patient volume and time on clinical diagnostic decision making in psychiatric emergency services. Gen Hosp Psychiatry. 2007;29:481-8 pubmed
    ..pressures on the role of gender and other nonpsychiatric factors in diagnostic decision making in psychiatric emergency services (PES). We reviewed the records of 1236 adult psychiatric patients treated by 75 clinicians (e.g...
  23. Machin Hamalainen S, Gimeno Santamaría M, Vázquez Piqué J, Gutiérrez Sánchez F. [Aristotle and compulsory transfers]. Aten Primaria. 2005;35:273 pubmed
  24. Zun L. Evidence-based evaluation of psychiatric patients. J Emerg Med. 2005;28:35-9 pubmed
    ..This review applies the rigors of evidence-based evaluation of the medical literature that is currently available to determine when it is safe to place a patient with behavioral complaints under psychiatric care. ..
  25. Edelsohn G, Rabinovich H, Portnoy R. Hallucinations in nonpsychotic children: findings from a psychiatric emergency service. Ann N Y Acad Sci. 2003;1008:261-4 pubmed
    ..Children with such presentations run the risk of being misdiagnosed as having psychosis or schizophrenia and being subjected to the inherent risks of treatment with antipsychotics. ..
  26. Jones R, Avies Jones A. An audit of the NICE self-harm guidelines at a local Accident and Emergency department in North Wales. Accid Emerg Nurs. 2007;15:217-22 pubmed
    ..Meanwhile the case note audit has reinforced the need for a practical self-harm pathway which will ensure consistency. ..
  27. Pascual J, Malagon A, Córcoles D, Gines J, Soler J, Garcia Ribera C, et al. Immigrants and borderline personality disorder at a psychiatric emergency service. Br J Psychiatry. 2008;193:471-6 pubmed publisher
    ..the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder. ..
  28. LINCOLN A, White A, Aldsworth C, Johnson P, Strunin L. Observing the work of an urban safety-net psychiatric emergency room: managing the unmanageable. Sociol Health Illn. 2010;32:437-51 pubmed publisher
    ..Our study demonstrates that staff of the PER face challenges on many levels as they struggle with the task of working with people presenting in psychiatric and social crisis. ..
  29. Miller L. On-scene crisis intervention: psychological guidelines and communication strategies for first responders. Int J Emerg Ment Health. 2010;12:11-9 pubmed
    ..The correct intervention in the first few moments and hours of a crisis can profoundly influence the recovery course of victims and survivors of catastrophic events. ..
  30. Agar L. Recognizing neuroleptic malignant syndrome in the emergency department: a case study. Perspect Psychiatr Care. 2010;46:143-51 pubmed publisher
    ..Early identification of this potentially life-threatening syndrome will lead to prompt treatment and improve the care of this vulnerable population. ..
  31. Reissman D, Schreiber M, Klomp R, Hoover M, Kowalski Trakofler K, Perez J. The virtual network supporting the front lines: addressing emerging behavioral health problems following the tsunami of 2004. Mil Med. 2006;171:40-3 pubmed
    ..Future disaster response and recovery efforts ought to build on the success of such virtual support networks, by planning for appropriate technology, expertise, and mutual aid partnerships. ..
  32. de Jong K, Kleber R. Emergency conflict-related psychosocial interventions in Sierra Leone and Uganda: lessons from Medecins Sans Frontieres. J Health Psychol. 2007;12:485-97 pubmed
    ..The years ahead of us are important for the development of psychosocial interventions. Fundamental issues such as programme evaluation need systematic research. ..
  33. Saks S. Call 911: psychiatry and the new Emergency Medical Treatment and Active Labor Act (EMTALA) regulations. J Psychiatry Law. 2004;32:483-512 pubmed
    ..New regulations of EMTALA went into effect on November 10, 2003. These new regulations helpfully clarify the applicability of EMTALA. However, the bias against recovery in cases involving psychiatric emergencies is likely to remain. ..
  34. Pichené C. [Rules for psychiatric emergency hospitalization]. Rev Prat. 2003;53:1214-9 pubmed
    ..The author describes in details the enforcement of the law in the case of hospitalization without patients's consent. ..
  35. Robertson C, McConville P, Lefevre P. Psychiatric characteristics of frequent attenders at accident and emergency: a case register comparison with non frequent attenders. Scott Med J. 2005;50:75-6 pubmed
    ..These patients have a combination of physical, psychiatric and social pathologies and the services to address these needs does not seem to currently exist but should be considered. ..
  36. Damsa C, Adam E, DE Gregorio F, Cailhol L, Lejeune J, Lazignac C, et al. Intramuscular olanzapine in patients with borderline personality disorder: an observational study in an emergency room. Gen Hosp Psychiatry. 2007;29:51-3 pubmed
    ..Sixteen percent of patients required a second IM olanzapine. Randomized, placebo-controlled studies are needed to confirm the efficacy of IM olanzapine in patients with acute agitation and BPD. ..
  37. Erdur B, Turkcuer I, Herken H. An unusual form of self-mutilation: tongue amputation with local anesthesia. Am J Emerg Med. 2006;24:625-8 pubmed
  38. Bernstein R. Commentary: commentary on the "choice" between seclusion and forced medication. Psychiatr Serv. 2008;59:212 pubmed publisher
  39. Cerel J, Currier G, Conwell Y. Consumer and family experiences in the emergency department following a suicide attempt. J Psychiatr Pract. 2006;12:341-7 pubmed
  40. Richard Y, Saint André S, Porchel G, Lazartigues A. [Evolution and description of a complete hospitalisation unity in child and teenager psychiatry]. Arch Pediatr. 2010;17:446-51 pubmed publisher
  41. Adesanya A. Impact of a crisis assessment and treatment service on admissions into an acute psychiatric unit. Australas Psychiatry. 2005;13:135-9 pubmed
    ..There is a need for further studies looking at a broader range of outcome variables in the assessment of the impact of CAT on psychiatric hospitalization in such settings. ..
  42. Broadbent M. Policy direction for emergency mental health triage. Aust Nurs J. 2008;15:33 pubmed
  43. Barry K, Milner K, Blow F, Impens A, Welsh D, Amash J. Screening psychiatric emergency department patients with major mental illnesses for at-risk drinking. Psychiatr Serv. 2006;57:1039-42 pubmed
    ..Both groups reported significant depression in the prior few days. This study demonstrated the importance of assessing alcohol use and depression among all patients in psychiatric emergency services.
  44. Pollard R, Yanasak E, Rogers S, Tapp A. Organizational and unit factors contributing to reduction in the use of seclusion and restraint procedures on an acute psychiatric inpatient unit. Psychiatr Q. 2007;78:73-81 pubmed
    ..These reductions maintained statistical significance even after controlling for changes in unit environmental variables. ..
  45. Watari M. [Comparison of emergency psychiatric services in Tokyo and Chiba prefecture]. Seishin Shinkeigaku Zasshi. 2005;107:877-81 pubmed
  46. Munetz M, Griffin P. Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness. Psychiatr Serv. 2006;57:544-9 pubmed
    ..Using the model, a community can develop targeted strategies that evolve over time to increase diversion of people with mental illness from the criminal justice system and to link them with community treatment. ..
  47. Nordentoft M, Søgaard M. Registration, psychiatric evaluation and adherence to psychiatric treatment after suicide attempt. Nord J Psychiatry. 2005;59:213-6 pubmed
    ..It is recommended that the quality of Reason for Contact Coding be improved, that patients who have attempted suicide be approached assertively, and that the supportive and guiding principle be used in securing them treatment. ..
  48. Milner K, Barry K, Blow F, Welsh D. Brief interventions for patients presenting to the Psychiatric Emergency Service (PES) with major mental illnesses and at-risk drinking. Community Ment Health J. 2010;46:149-55 pubmed publisher
  49. Niquille M, Hausser J, Rubovszky G. [Somatic and psychiatric emergencies: building a mutual view]. Rev Med Suisse. 2009;5:1595-9 pubmed
    ..Due to the complex relationship between somatic and psychiatric disorders, a close collaboration between psychiatrists and EPs is crucial for efficient and patient care, as well as developing teaching and research. ..
  50. Giggie M, Olvera R, Joshi M. Screening for risk factors associated with violence in pediatric patients presenting to a psychiatric emergency department. J Psychiatr Pract. 2007;13:246-52 pubmed
    ..Most psychiatric residents failed to document thorough risk assessments for violence in pediatric patients in an emergency setting. This has important medical-legal and treatment planning implications. ..
  51. Hirshbein L, Gay T. Case-based independent study for medical students in emergency psychiatry. Acad Psychiatry. 2005;29:96-9 pubmed
    ..Case-based independent study is an effective method to improve exposure to emergency psychiatry cases during a third-year medical student clerkship. ..
  52. Schillerstrom T, Schillerstrom J, Taylor S. Laboratory findings in emergently medicated psychiatry patients. Gen Hosp Psychiatry. 2004;26:411-4 pubmed
    ..001), and alanine aminotransferase (P<.05). Emergently medicated patients in this psychiatry emergency service were more likely to be older and more likely to have abnormal laboratories vs other adult patients. ..
  53. Margolin J, Mester R. Inverted Tarasoff. Isr J Psychiatry Relat Sci. 2007;44:71-3 pubmed