Psychiatric consultation in the emergency setting

Abstract

Consultants may be called to an emergency department for a variety of reasons. Most requests are like those from a general hospital ward. However, two issues are notable: A broader definition of psychiatric emergencies and greater concern about patient rights. These issues stem from an emergency department’s lack of a buffer from its surrounding community: Patients come as they are, whether pushed, or just so inclined, whether in crisis, or just avoiding clinic appointment delays. There is little or no time for patients and emergency department staff to come to any understanding. In this absence of a traditional physician–patient relationship, consultants may be forced to change their usual approach.