By Paul Linde
The psychiatric emergency room, a fast moving wrestle sector with strain to compare, thrusts its scientific prone into the outland of human event the place they need to reply quickly and decisively despite uncertainty and, quite often, possibility. during this energetic first-person narrative, Paul R. Linde takes readers behind the curtain at an city psychiatric emergency room, with all its chaos and pathos, the place we witness psychological future health pros doing their most sensible to relieve ache and service shattered lives. As he and his colleagues come across sufferers who're hallucinating, inebriated, catatonic, competitive, suicidal, excessive on medicines, paranoid, and bodily unwell, Linde examines the various moral, felony, ethical, and scientific matters that confront today's psychiatric services. He describes a occupation less than siege from the outside--health insurance firms, the pharmaceutical undefined, govt regulators, or even "patients' rights" advocates--and from the inside--biomedical and educational psychiatrists who've forgotten to deal with the sufferer and feature as a substitute turn into checklist-marking pill-peddlers. whereas lifting the veil on a vital quarter of psychiatry that's as actual because it will get, Danger to Self additionally injects a hearty dose of compassion into the perform of medication and psychiatry.
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Additional resources for Danger to Self: On the Front Line with an ER Psychiatrist
JAMA 268:3441–3445, 1992 Kates N, Eaman S, Santone J, et al: An integrated regional emergency psychiatry service. Gen Hosp Psychiatry 18:251–256, 1996 Lamb HR, Lamb DM: A nonhospital alternative to acute hospitalization. Hosp Community Psychiatry 35:728–730, 1984 Lazarus A: Dumping psychiatric patients in the managed care sector. Hosp Community Psychiatry 45:529–530, 1994 Marder D: Hospital policy: responding to COBRA. Emergency Psychiatry 3:31–33, 1997 Marshall PE: The mental health HMO: capitation funding for the chronically mentally ill.
Grounded in the biopsychosocial model, these curricula stress an integrated approach to mindbody health. Frequency of Medical Morbidity Determining exact rates of medical comorbidity in psychiatric patients has been problematic, because several studies did not include control groups, and because the patient cohorts studied varied by age, location, and year of study. However, evidence does suggest that patients with psychiatric disorders commonly present with comorbid medical problems (Table 2–1).
Community Ment Health J 9:18–24, 1973 Saunders CE: Time study of patient movement through the emergency department: sources of delay in relation to patient acuity. Ann Emerg Med 16:1244–1248, 1987 Schneider SM, Hamilton GC, Moyer P, et al: Definition of emergency medicine. Acad Emerg Med 5:348–351, 1998 Schuster JM: Frustration or opportunity? The impact of managed care on emergency psychiatry. New Dir Ment Health Serv 67:101–108, 1995 32 EMERGENCY PSYCHIATRY Soreff S: New directions and added dimensions in home psychiatric treatment.
Danger to Self: On the Front Line with an ER Psychiatrist by Paul Linde