Every emergency room approaches psychiatrist staffing differently.
As I previously wrote, not every emergency room has a staff psychiatrist available. If a psychiatrist is not available on site, some emergency rooms may have a consultant psychiatrist see you via telemedicine. Other emergency rooms may transfer you to a psychiatric emergency room (PES) or a crisis stabilization unit (CSU), two types of sites for emergency psychiatric care I will cover in future posts.
Wherever you ultimately see the psychiatrist, it's important to remember that these interactions are typically much shorter and more targeted than a standard psychiatric intake evaluation.
In many ways, emergency psychiatry is its own subcategory of psychiatry, even though it is not a board-certified subspecialty of the field. By this I mean that there is no officially recognized exam to show that a person has very specific knowledge of emergency psychiatric care. However, the job itself requires that a psychiatrist develop a unique set of skills that lends itself to the fast-paced environment of the emergency room and to the types of situations that often lead people to need psychiatric care urgently.
Typically you will find that an emergency room psychiatrist will want to cover the same categories of information with you that would be covered by an outpatient psychiatrist. However, meeting with a new outpatient psychiatrist can mean several hour-long sessions before developing your initial care plan. In contrast, emergency psychiatry evaluations are typically about 30 minutes total, including initial care plan development.
Away from the bedside, emergency room psychiatrists will also work with the emergency room staff and other psychiatric facilities to coordinate your care moving forward.
When I work with patients in emergency rooms, I always try to educate them that emergency rooms work in shifts, with staff swapping out every 8 or 12 hours. As a result, it also means that we evaluate how you and your care plan are doing several times a day to make sure we are on the right track. As a result, emergency room psychiatric care moves much faster than typical outpatient care where you are seen once a month or so. However, there is the trade off that, with the constant flow of new patients to be seen, the care must be delivered in briefer, as needed, segments.
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