Psychiatric emergency services

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In some areas of the United States, Psychiatric Emergency Services (PES) are a type of acute psychiatric facility that is available for mental health emergencies. They are generally open 24 hours a day in the United States, although most well developed countries will have one in some form or another. Mental health provision for the indigent in the United States is divided by counties, after the passage of a federal Community Mental Health Act of 1963.

1 Employees
2 Patient Care
3 History
4 Services
5 See also

[edit] Employees

Most large counties have established a PES, or similarly named facility to handle emergency cases. The staff of an emergency psychiatry unit may consist of psychiatrists (MD), registered nurses (RN), psychologists (PhD), social workers (MSW), psychiatric technicians (like a hospital orderly), clerical staff and security officers.

[edit] Patient Care

These units often provide the most severely ill patients with acute care from the Mental Health System. A PES clinic may be located within a general medical hospital, within a psychiatric hosptial, or as a free-standing clinic in its own right. PES helps coordinate care for the most severely ill in a county. PES clinics are specific clinics for patients to be referred to for emergency care.

Patients may arrive in several ways:

1.They could be taken in by the police for psychiatric evaulation 2.sent from other emergency rooms; 3.sent from outpatient clinics; 4.referred from physician's offices; 5 brought in by family or friends; or by 6 voluntary presentation by the individual.

PES clinics are often locked due to the possibly violent nature of the patients. Not all patients are involuntarily committed in PES clinics, but many are. Often the person is too ill to know they are ill and must be brought in by others. Mental health laws vary from state to state and country to country, but people can generally only be held against their will (involuntary commitment) for being a danger to themselves, danger to others, or the inability to provide food, clothing and shelter for themselves. In the past 30 years mental health laws have become much stricter meaning that persons can only be involuntarily committed if they meet the above criteria. Simply having a mental illness is almost never grounds for detaining someone.

[edit] History

In the past, chronically ill patients were committed to state hospitals, often for years. In the 1970s-1980s many state hospitals were closed in a process called deinstitutionalization. It was generally considered to be unsuccessful as there were no suitable place for committed patients to go. This has led to an increase in the homeless population. Many patients that are seen frequently in a PES would in the past have been committed to a state hospital.

[edit] Services

Typical psychiatric emergencies involve suicidal thoughts, psychosis and drug intoxication. These are not specific diagnoses, but patients often fall into one of these categories.

Often patients can stay in an emergency psychiatric facility for up to 24 hours. After which there are several possibilities. Patients may be admitted to an in-patient psychiatric unit. They may be transferred to a medical unit, if they have an underlying, non-psychiatric, general medical problem. Patients may be discharged to home, to a friend, to an unlocked facility in the community or to a shelter.

Other names for these facilities include: