Psychiatric Illness in the Emergency Department

Abstract

A substantial number of patients with mental illness present to emergency departments (EDs) for treatment, and their numbers are continuing to rise. Patients with substance use disorders are the most common, but there are also patients with suicidal ideation or those who have already attempted suicide, as well as patients with psychosis, altered mental status, and acute anxiety disorders. Among patients with substance use disorders, “traditional” drugs of abuse (ie, alcohol, marijuana, cocaine) continue to predominate, but there is an increasing number of patients who present with intoxication caused by “designer” drugs, which are much harder to detect. Suicide attempts remain a leading cause of ED presentation and require ED personnel to not just do triage and in-depth assessment, but also to make recommendations for adequate follow-up. This article focuses on the epidemiology of mental health visits to the ED and reviews the most common mental health conditions that ED medical staff are likely to encounter. [ Psychiatr Ann. 2018;48(1):21–27.]

Evidence of validity of the instrument interRAI emergency screener for psychiatry for the brazilian context

“…The next most frequent are those with psychosis, altered mental status and acute anxiety disorders. Suicide attempts require in-depth screening, evaluation and recommendations on subsequent follow-up (Hashmi et al, 2018). National data from the Canadian Institute for Health Information (Canadian Institute for Health Information, 2017) show that 32% of people seeking ER are for mental health issues only, 18% are due to substance use disorders and 50% seek care for both mental health disorders and addictions.…”