Psychiatry in Emergency Settings

Carlo Carandang, MD, obtained his medical degree at the University of Texas Medical Branch at Galveston. Over the course of a psychiatric career spanning more than a decade, Dr. Carlo Carandang has served in a number of positions, including as an emergency psychiatrist at IWK Health Centre in Halifax, Nova Scotia.

Emergency psychiatry is a broad term used to describe psychiatric services administered in an emergency situation. A frequent setting for this type of psychiatry is the emergency room, where psychiatric evaluations need to take place in a timely manner. Individuals in need of an evaluation due to symptoms of severe mental illness are often brought to the emergency room on the basis of a Mental Health Hold. These holds are designed to allow police officers to bring in people who are posing a threat to their own safety and the safety of others due to their illness.

Attendants at the emergency room will often perform a drug screen and toxicology report to make sure an individual is medically cleared for an evaluation. This process can take up to eight hours, and longer if complications arise. If an evaluation has been requested by a member of the family, it is recommended they bring a complete history of the patient’s past medical and mental issues. The evaluation itself consists of four parts: a one-on-one interview, gathering information from outside sources and documents, consulting with relevant professionals, and a disposition period.