Abstract
Emergency psychiatry is developing as an important subspecialist discipline. This is most apparent in the US, where the specialist psychiatric emergency service (PES) has been developed in many areas. In Australia and New Zealand many mainstream general psychiatric services have become defacto psychiatric emergency services. There has been a general rise in emergency department attendance for acute psychiatric problems and widespread anecdotal evidence of increasing acuity, complexity, and dangerousness of clinical presentation to acute psychiatric services. This increases the demand for emergency psychiatric skills in both general psychiatry and in specialist psychiatric emergency services. This volume attempts to meet both needs.
The first chapter provides an overview of the structure and function of psychiatric emergency services, including a review of different models for service delivery. Chapter two provides a general overview of medical, psychiatric and cognitive assessment in the PES. Chapter three more specifically covers the assessment and treatment of suicidal patients in an emergency setting. Chapter four reviews the emergency treatment of agitation and aggression. Chapter five describes psychosocial interventions in the PES.
This book is definitely not a handbook of emergency psychiatry, and will be of little immediate use to the clinician confronted with an acute psychiatric emergency. Nevertheless, it is a well written and scholarly (if brief) review, particularly pertaining to the US. The book is heavily referenced, which is useful, given an unfortunate lack of depth on most topics which is probably a consequence of the series format.
This book will mainly interest policy makers, service planners, managers, and clinical leaders. As a practising acute psychiatrist, there was much I found useful. The overview of models of psychiatric emergency service delivery was particularly interesting, given the tendency to myopic views from within one's own institution.