Psychiatric Illness in the Emergency Department – 2018

A substantial number of patients with mental illness present to emergency departments (EDs) for treatment, and their numbers are continuing to rise. Patients with substance use disorders are the most common, but there are also patients with suicidal ideation or those who have already attempted suicide, as well as patients with psychosis, altered mental status, and acute anxiety disorders. Among patients with substance use disorders, “traditional” drugs of abuse (ie, alcohol, marijuana, cocaine) continue to predominate, but there is an increasing number of patients who present with intoxication caused by “designer” drugs, which are much harder to detect. Suicide attempts remain a leading cause of ED presentation and require ED personnel to not just do triage and in-depth assessment, but also to make recommendations for adequate follow-up. This article focuses on the epidemiology of mental health visits to the ED and reviews the most common mental health conditions that ED medical staff are likely to encounter.

Ali M. Hashmi, MD; Kim-Lan Czelusta, MD; Qammar Jabbar, MBBS; Samia Siddiqui, MBBS; Asim A. Shah, MD
Psychiatric Annals, 2018