Emergency department staff need help dealing with psychiatric patients

Editor’s Note: This post is part three of our look at emerging trends in emergency psychiatry. Part one looked at Comprehensive Psychiatric Emergency Programs (CPEP), and part two highlighted mobile crisis units and telepsychiatry. Check in next week to download a PDF of the entire series. In a time of decreasing reimbursement, it is not easy for facilities to implement psychiatric emergency programs such as Comprehensive Psychiatric Emergency Programs (CPEP), mobile units, or dedicated telephyschiatry units. The problem is compounded by the fact that psychiatric patients are notoriously under- or un-funded, says Dr. Leslie Zun, Chairman of the Department of Emergency Medicine at Mount Sinai Hospital in Chicago. “What hospital in this country wants to add a service that doesn’t pay?” Dr. Zun asks. Converting an existing space into an appropriate emergency psychiatric space for a CPEP or dedicated telepsychaitry unit that houses multiple patients can cost millions, Zun says. And purchasing the equipment for a mobile emergency psychiatric unit can be equally expensive. The hard truth is that many facilities see boarding psychiatric patients in the emergency department (ED) as standard operating procedure. In that case, it is essential that ED staff understand the needs of psychiatric patients in order to ensure the services they receive while boarded in the ED are the same as they would receive on the floor, Zun says. National Update on Behavioral Emergencies Dr. Zun developed a national two-day conference to help ED staff understand and treat psychiatric patients. he National Update on Behavioral Emergencies, now in its 3 ^rd year, looks at cutting edge techniques for emergency psychiatry and discusses issues such as psychiatric boarding, discharge decisions, and ED treatments. “We all agree that emergency physicians, psychiatrists, nurse practitioners, and social workers need help when dealing with psychiatric patients in the ED,” Dr. Zun says. The following are a few of the topics that will be discussed at this year’s conference, which will be held in Las Vegas December 5-7, 2012:

• New drugs of abuse
• Pediatric behavioral emergencies
• Difficult patient presentations
• Providing psychiatric care with limited resources
• Who can go home with suicidal thoughts

Emergency psychiatry certification Those who attend the National Update on Behavioral Emergencies earn continuing medical education (CME) credits that may be applied towards American College of Emergency Physicians (ACEP) and American Medical Association (AMA) credentials. At this time there is no specific certification for emergency psychiatry services, but the American Association of Emergency Psychiatrists (AAEP) is looking into developing one, says Dr. Scott Zeller, Chief of Psychiatric Emergency Services at Alameda County Medical Center and president of the AAEP. Doing so would be a step towards standardizing emergency psychiatry and improving patient care. About Barton Associates Established in 2001, Barton Associates is a leading national locum tenens staffing company serving emergency medicine physicians as well as psychiatrists, psychiatric nurse practitioners, and psychiatry practices across the U.S. Learn more about Barton’s emergency medicine, psychiatrist, and psychiatry nurse practitioner staffing solutions and locum tenens jobs at http://64.207.156.120. Barton’s other medical specialties include Anesthesiology, Dermatology, Family Medicine, Hospitalist, Internal Medicine, Pediatrics, Oncology, Primary Care, Psychiatry, Radiology, Surgery, and many more.