Emergency Department Treatment of the Psychiatric Patient: Policy Issues and Legal Requirements

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Many hospital emergency departments are overcrowded and short-staffed, with a limited number of available hospital beds. It is increasingly hard for emergency departments and their staff to provide the necessary level of care for medical patients. Caring for people with psychiatric disabilities raises different issues and calls on different skills.
In Emergency Department Treatment of the Psychiatric Patient, Dr. Stefan uses research, surveys, and statutory and litigation materials to examine problems with emergency department care for clients with psychiatric disorders. She relies on interviews with emergency department nurses, doctors and psychiatrists, as well as surveys of people with psychiatric disabilities to present the perspectives of both the individuals seeking treatment, and those providing it.
This eye-opening book explores the structural pressures on emergency departments and identifies the burdens and conflicts that undermine their efforts to provide compassionate care to people in psychiatric crisis. In addition to presenting a new analysis of the source of these problems, Dr. Stefan also suggests an array of alternatives to emergency department treatment for people in psychiatric crisis. Moreover, the author proposes standards for treatment of these individuals when they do inevitably end up in a hospital emergency department.
Emergency Department Treatment of the Psychiatric Patient presents a thoughtful and thorough analysis of the difficulties faced by people with psychiatric disabilities when seeking emergency medical care. It is essential reading for anyone working in a hospital emergency department, as well as health care policy makers, and advocates and lawyers for people with psychiatric disabilities.

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Editorial Reviews

From the Publisher
"Emergency Department Treatment of the Psychiatric Patient is a marvelous work. It shows us the ED through the eyes of the patient. Even more important, it shows us how rules and procedures can be set up that help ED personnel to respect and support people with mental illness during what are often their worst moments. This book should be read by everyone who works with people with mental illness."—Charles W. Lidz, Ph.D., Research Professor of Psychiatry, Director, Center for Mental Health Services Research, University of Massachusetts Medical School

"Although more by default than design, hospital emergency departments have become settings where the nation's failures in addressing the needs of people who have mental illnesses are routinely played out. For many of these individuals, the emergency department has come to represent less a safe haven and a gateway to care than yet another affirmation of how a "mental patient" is an unwanted burden. Ms. Stefan's thoughtful analysis of this scenario and recommendations for improvements make Emergency Department Treatment of the Psychiatric Patient essential reading for anyone concerned about the disjuncture between physical and mental healthcare and the nation's urgent need for meaningful reform."—Robert Bernstein, Ph.D., Executive Director, Bazelon Center for Mental Health Law

"Emergency Department Treatment of the Psychiatric Patient includes a set of valuable proposals by experts for standards of care for emergency mental health treatment. As an overview of current conditions and futures directions, [this] book will serve as a valuable handbook and reference handbook for clinicians who work in emergency settings, for emergency room physicians, for health planners, and for attorneys and other advocates who work with persons with serious mental illness."— Robert M. Factor, M.D., Ph.D., Medical Director, Emergency Services, Mental Health Center of Dane County

"...a concise yet comprehensive discussion of these various problems and challenges from both a macro and micro level...it is an excellent work...appropriately organized and clearly written and consider it a must-read for health care professionals across disciplines who practice in the area of emergency medicine."—PsycCRITIQUES

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Product Details

  • ISBN-13: 9780195189292
  • Publisher: Oxford University Press
  • Publication date: 3/16/2006
  • Series: American Psychology-Law Society Series
  • Pages: 232
  • Product dimensions: 9.40 (w) x 6.40 (h) x 1.20 (d)

Meet the Author

Susan Stefan, J.D., directs the National Emergency Department Project at the Center for Public Representation, based in Massachusetts. The Project seeks to improve the care of people with psychiatric disabilities when they are in crisis. Dr. Stefan, formerly at the University of Miami School of Law, is a leading authority on the civil rights of people with mental illnesses. She is a litigator and policy advocate, and author of two books, including Unequal Rights: Discrimination against People with Mental Disabilities and the Americans with Disabilities Act. She lives with her husband and dog in Rutland, Massachusetts.

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Table of Contents

Series Foreword
1. Introduction
2. Overview of Psychiatric Emergency Services
3. Patients' Problems in Emergency Room Care
4. Professional Issues in Emergency Department Care
5. Legal Rights and Standards in Emergency Room Treatment of People with Psychiatric Disabilities
6. Solutions to Problems in Emergency Department Treatment of People with Psychiatric Disabilities
7. Conclusion
Appendix A Center for Public Representation: Findings and Proposed Standards

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