A call for behavioral emergency response teams in inpatient hospital settings

Abstract

Medical rapid response teams, now ubiquitous throughout hospitals, were designed to identify and proactively treat early warning signs of acute medical decompensation. Behavioral emergencies-including clinical psychiatric emergencies, coping/stress reactions, and iatrogenic injuries-are not responded to with the same vigor. At worst, behavioral crises are treated as unarmed security threats. Limited or inappropriate responses to such crises can lead to suboptimal outcomes on numerous levels, especially avoidable harm to patients and frontline clinicians. Widespread implementation of behavioral emergency response teams for patient-centered behavioral interventions has been impeded by a pervasive perception that these endeavors are medically unnecessary and optional. This article calls for a paradigm shift in responding to behavioral emergencies by arguing that security-driven risk management practices during behavioral emergencies are incompatible with fundamental medical and ethics principles.