An Innovative, Nurse-Led Service for Appropriate Management of Psychiatric Emergencies: Initial Findings

The emergency department (ED) physicians working for the French Service d'Aide Medicale d'Urgence (SAMU) refer about 84% of individuals who contact SAMU for psychiatric problems to the psychiatric ED (PED), compared with only 20% of those calling with other medical emergencies. Physicians' lack of psychiatric knowledge may contribute to the high PED referral rate. The authors created a new psychiatric nurse-led service to improve the identification of psychiatric emergencies and assessed PED referrals and inpatient hospitalization rates before and after the new service commenced. After service implementation, the proportion of PED-referred patients fell from 84% to 38%, and inpatient hospitalization rates for those referred to the PED increased from 27% to 36%.