| Popis: |
Mental-health-related visits to emergency departments are common and steadily increasing [1–3]. More than ever, emergency departments (EDs) have become burdened with longer wait times, overcrowding, and complex patient safety issues. Patients with primary psychiatric complaints, numbering approximately 53 million from 1992 to 2001 in the United States, now constitute 12.5% of all adult ED visits [1, 4]. This rise in mental health visits corresponds to a 38% increase [5]. At the same time, there has been an increasing shortage of inpatient psychiatric beds nationally, with a decline in a number of inpatient beds per capita of 62% from 1970 to 2003 [6]. Frequently, there is an inherent challenge or even fear in dealing with these patients and their behavioral symptoms due to discomfort in diagnosing and managing psychiatric conditions, such that the medical aspects of psychiatric care are overshadowed in order to arrange a rapid disposition. Sigmund Freud once famously noted, “When I treat a psychoneurotic, for instance, hysterical patient … I am compelled to find explanations for the first symptoms of the malady, which have long since disappeared, as well as for those existing symptoms which have brought the patient to me; and I find a former problem easier to solve than the more exigent one of today” [7]. |
