Psychiatric emergencies: rapid response and life-saving therapies

Mental status in older patients can be acutely affected by a range of factors, particularly polypharmacy, disorders of cognition, psychosis, and elder abuse. Patients so affected may be agitated, uncooperative, combative, suicidal, or incapable of participating in treatment decisions. In a life-threatening emergency, a patient may need to be restrained or a treatment administered against a patient's wishes. Key to successful management of psychiatric emergencies is an awareness of the potential scenarios, familiarity with appropriate interventions, and an understanding of patient rights. An increased alertness for life-threatening behaviors can help prevent an event from worsening and minimize the likelihood of a patient acting out on a threat of violence or suicide.