Asha Emergency Psychiatry
- There is an increase in patients presenting to emergency departments with acute psychiatric crises.
- Although acute psychiatric crises qualify as medical emergencies, the general hospital emergency department might not be the best location of care for these cases.
- What is needed is a comprehensive psychiatric emergency program in the context and location of a stand-alone psychiatric hospital, as most of the general hospital emergency units don’t take the most acute and highly agitated or violent patients.
- The problem is further compounded when such a violent patient has a comorbid physical illness.
- Asha emergency department consists of qualified Psychiatrists and trained Nursing staff working 365 days.
- The only 24 hour exclusive emergency and consultation-liaison psychiatry department in the city manned by qualified psychiatrists round the clock.
To address these treatment gaps, we have started the Comprehensive Emergency Psychiatry Program (CPEP) at Asha Hospital, by establishing an Emergency and Consultation-Liaison Psychiatry Department.
The main purpose and functions of CPEP at Asha Hospital:
- Excluding medical aetiologies of symptoms and ensuring medical stability
- Rapidly stabilise the acute crisis
- Avoid coercion
- Treat in the least restrictive setting
- Form a therapeutic alliance
- Formulate an appropriate aftercare plan
- The Emergency Department works round the clock and accepts the patients 24/7 x 365 days
- It is staffed at all times by a psychiatrist, nurses, and other ancillary staff trained to handle any psychiatric and medical emergency.
- The psychiatric emergency department at Asha works in close interaction with the High Dependency medical unit which also operates 24/7 and is staffed with an Intensivist/physician and other supporting staff and located in the same premises.
- Those who are stabilised in an emergency room if required are admitted into the inpatient unit of the hospital.
The role of standalone psychiatric emergency services as safe, efficient and patient-centred facilities is well documented across the world and the CPEP at ASHA provides the much-needed service in the area of Emergency psychiatry.
EMERGENCY AND CONSULTATION-LIAISON PSYCHIATRY DEPARTMENT:
SCOPE OF SERVICES :
- The only 24-hour exclusive emergency and consultation-liaison psychiatry department in the city manned by qualified psychiatrists round the clock
- Management of psychiatric emergencies including Aggression, Suicidality, Drug withdrawal or intoxication Medical emergencies presenting with behavioural symptoms.
- Availability of observation facility at nominal charges in the emergency psychiatry department itself.
- Liaison with attached ICU with visiting specialists from all departments for diagnosis and management of behavioural emergencies due to underlying physical conditions.
- Management of mild to moderate medical comorbidities in patients with psychiatric problems.
- Liaison with 2 general hospitals for Management of severe medical comorbidities with staff from our hospital visiting these centres thereby enhancing continuity of care.
- Visits to various general hospitals to assess psychiatric emergencies and a need for shifting to our specialist psychiatric centre.
- Availability of a depot injection clinic for administration of long-acting injectable medications.
When a personhas a disturbance in their mood, thoughts, or behavior that could result in danger to them or others around them , it is considered a psychiatric emergency. This can consist of suicidal thinking or disorganized thinking. If a person is unable to care for their basic needs due to mental illness, that also may be considered a psychiatric emergency.
Reasons to bring someone for an emergency mental health evaluation include:
Risk of harm to self, such as:
- Saying that they want to kill themselves
- Hurting themselves intending to die
- Planning and taking steps to kill themselves
Risk of harm to others, such as:
- Becoming more violent and aggressive towards others
- Saying that they plan to harm others, threatening others
- Destroying property
Changes in behaviour or thinking, such as:
- Acting strangely
- Talking strangely, not making sense
- Being falsely suspicious that others are trying to harm them
- Losing touch with reality
- Seeing or hearing things that are not there
- Becoming fearful without reason
- Wandering away from home
- Not taking food
If you believe that you or a loved one are experiencing a situation as mentioned above and are worried for your safety, it is advisable to access emergency psychiatric care immediately
Conditions mostcommonly requiring Emergency Psychiatric Services mayinclude persons with
- Acute psychosis (for eg: schizophrenia, drug induced psychosis)
- Mood disorders: Bipolar disorder, suicidal depression
- Substance abuse: Drug intoxication or withdrawal
- Acute anxiety and panic attacks
- Violence can also be associated with other conditions such as personality disorders or other neurological impairments
- A psychiatric and physical assessment will be undertaken immediately on presentation andsuggestions regarding immediate and further treatment will be made.
- Immediate care to secure the safety of the patient and others around them is prioritised. We are equipped with adequate security and infrastructure to ensure the same.
- We have options for inpatient management (including in a high dependency medical unit (HDMU) if necessary), observation facility in the emergency premises, and outpatient management.
- Referrals may be made to other general hospitals if it is deemed by the emergency psychiatric team that the patient has a medical emergency which needs specific evaluation or treatments which are not available at our centre.
The psychiatric assessment will attempt to clarify information about the following:
- Current symptoms
- Onset, duration and progression of symptoms
- Any previous history of mental health problems (It is usually beneficial to carry old treatment records if available)
- Any history of substance use
- Any history of physical medical problems and concerned treatments
A basic physical examination is done to screen for any physical problems and a mental status examination is done to evaluate for psychological abnormalities. Based on findings from all of the above, recommendations are made for further management
We also offer Consultation-Liaison services on an as-needed basis, i.e, if your family member is admitted in a general hospital and needs a psychiatric evaluation, in case the hospital does not have a psychiatrist available, you can approach us for the same, and if allowed by the treating hospital, one psychiatrist from our emergency team will visit the patient wherever they are admitted and carry out a psychiatric evaluation. This also ensures a further pathway for continuity of care of the psychiatric problem in our hospital, once the acute medical treatment is done.
We are a team comprised of consultant psychiatrists, nursing staff and security personnel working round the clock in close liaison with ICU specialists to provide 24×7 emergency psychiatric help.
You can call 040-23542835, 040-23542838 and enquire regarding the emergency psychiatry department for any further queries.