Evaluation of the psychiatric patient

Patients presenting to the emergency department (ED) with behavioral disturbances account for approximately 6% of all ED visits. Emergency physicians are often responsible for the initial assessment of these patients' psychiatric complaints, which might include homicidal and suicidal behavior and acute psychosis. The emergency physician might be asked to provide medical clearance before transfer to definitive psychiatric care. The purpose of the medical screening is to identify medical conditions that might be causing or contributing to the psychiatric emergency or that might be dangerous or inappropriate to treat in a psychiatric facility. Appropriate treatment in the ED is essential to avoid morbidity and mortality resulting from misdiagnosis of medical conditions as psychiatric illnesses and from mismanagement of psychiatric illnesses.