Consumers’ Wants And Needs During A Psychiatric Emergency PDF Print E-mail

Top recommendations for improving emergency psychiatric care generated by consumer
workshops (organized by phase of the emergency services process)

  • Initial in-community contact by crisis staff, police, or others
    Alternatives to traditional emergency services that include peer support personnel. Such alternatives include hot and warm lines, mobile crisis intervention teams,
    and respite and admission diversion residential services.

    Increased use of advance directives and other crisis prevention and resolution plans.

    More hopeful first contact: more humanistic, decriminalized, and anxiety-reducing initial community contact bypolice, crisis response, and emergency services personnel,
    who do not rush to restrain, presuming the threat of violence, and who convey hope and encouragement for recovery.

  • Intake and waiting
    Comfortable physical environment: more physically comfortable waiting areas, preferably separate from thegeneral ER, which provide privacy and opportunities to
    address basic human needs (i.e., food and drink, unlockedtoilet facilities, reading material, a comfortable place to sit or lie down to rest).

    Interpersonal emotional support: emotionally comforting and rapid intake process implemented by skilled, sensitive, and empathic personnel, who communicate frequently
    and effectively with recipients about their needs and the status of the process and who allow individuals to verbally express anger and frustration without fear of reprisal.

    Availability of peer advocate support or support from other known and trusted persons (e.g., family member,friend, advance directive agent) throughout all aspects of the
    emergency services process.

  • Assessment and service planning
    Respected person orientation: a nonstigmatizing, person-oriented approach in which people are not treated asdiagnostic labels or symptom clusters: responsive listening
    and respectful attention to persons in crisis, who should be treated as credible reporters about their history, preferences, and needs.

    Improved staff training: expansion of training opportunities to increase the understanding and improve the attitudes and skills of all individuals
    (police, crisis workers, hospital administrators and staff) who are involved in serving and supporting individuals  experiencing a psychiatric crisis.

  • Treatment interventions
    Patient-practitioner partnerships: patient involvement in informed consent decision-making, sharing of information about medications and other treatment options,
    and protection of patient choice and rights throughout all aspects of the assessment, treatment planning, treatment, and discharge process.
    Consumers stressed the importance of staff using the least intrusive interventions possible and being asked about medications
    that have helped them in the past and about medications they prefer.

  • Referral or discharge and follow-up
    Survival supports during transitions: ensuring that post-discharge needs (e.g., medications, safe housing,preparation and support of family and other support persons,
    links to outpatient services and peer support) are inplace before discharge.

  • Post-discharge contacts: follow-up phone calls and visits by mental health staff and/or peer support specialiststo assist and support individuals in
    obtaining post-discharge services.

    Ref: Journal of Psychiatric Practice Vol. 9, No. 1 54 January 2003