Mapping clinical interactions in an Australian tertiary hospital emergency department for patients presenting with risk of suicide or self-harm: Network modeling from observational data

Background: Reliable assessment of suicide and self-harm risk in emergency medicine is critical for effective intervention and treatment of patients affected by mental health disorders. Teams of clinicians face the challenge of rapidly integrating medical history, wide-ranging psychosocial factors, and real-time patient observations to inform diagnosis, treatment, and referral decisions. Patient outcomes therefore depend on the […]

Designing implementation strategies for a digital suicide safety planning intervention in a psychiatric emergency department: Protocol for a multimethod research project

Background: Suicide prevention is currently a national health priority in Canada. Emergency departments (EDs) are critical settings for suicide prevention, and in our local psychiatric ED at the Centre for Addiction and Mental Health, we plan to embed an app-based tool called the Hope app to support suicide safety planning intervention. The app is free and […]

Mechanical restraint in inpatient psychiatric unit: Prevalence and associated clinical variables

Background and Objectives: mechanical restraint (MR) is a controversial issue in emergency psychiatry and should be better studied to implement other alternative therapeutic interventions. The aim of this study was to estimate the prevalence of MR in an Italian psychiatric unit and identify the sociodemographic and clinical characteristics as well as the pharmacological pattern associated […]

Universal suicide screening in emergency departments across a large healthcare system

Background: Suicidal ideation is a common complaint in Emergency Departments (EDs) across the United States (US) and is an important preventable cause of death. Consequently, current Joint Commission guidelines require screening high-risk patients and those with behavioral health needs for suicide. Accordingly, we implemented universal suicide screening for all patients presenting to EDs in our healthcare […]

Effectiveness of psychotherapy on prevention of suicidal re-attempts in psychiatric emergencies: A systematic review and network meta-analysis of randomized controlled trials

Objectives: We conducted a systematic review and network meta-analysis to evaluate the relative effects of psychological interventions for preventing suicide re-attempts in psychiatric emergencies. Methods: We searched PubMed, Embase, Cochrane, and PsycINFO from inception to December 1, 2022. Selection and data extraction were conducted independently by two reviewers based on prespecified criteria. We evaluated the efficacy of […]

Established outpatient care and follow-up after acute psychiatric service use among youths and young adults

Objective: This study explored follow-up after hospitalization and emergency room (ER) use for mental health among youths and young adults with private insurance. Methods: The IBM MarketScan commercial database (2013-2018) was used to identify people ages 12-27 with a mental health hospitalization (N=95,153) or ER use (N=108,576). Factors associated with outpatient mental health follow-up within 7 and […]

Patients with borderline personality disorder in emergency departments

Borderline personality disorder (BPD) patients, when in crisis, are frequent visitors of emergency departments (EDs). When these patients exhibit symptoms such as aggressiveness, impulsivity, intense anxiety, severe depression, self-harm, and suicidal attempts or gestures, diagnosis, and treatment of the BPD becomes challenging for ED doctors. This review will, therefore, outline advice to physicians and health-care […]

Borderline personality disorder in the emergency department: Good psychiatric management

Patients with borderline personality disorder (BPD) are high utilizers of psychiatric emergency services and present unique challenges in that setting. Frequently advised to visit an emergency department (ED) if safety is in question, their experiences once there often do not have beneficial effects. Issues specific to patients with BPD in the ED include volatile interactions […]

Effect of the SARS-COV-2 pandemic outbreak on the emergency department admission for an acute psychiatric condition”

Preliminary evidence seems to suggest a reduction in absolute terms of Emergency Department (ED) admissions for an acute psychiatric condition during the first months of the pandemic. The study aimed to test through a long-term time analysis the effect of COVID-19 on changes in ED visits for an acute psychiatric condition. A quasi-experimental interrupted time […]

Lethal means assessment in psychiatric emergency services: Frequency and characteristics of assessment

Objective Lethal means safety is an effective suicide prevention strategy with demonstrated results at the population level, yet individual-level uptake is less well understood. Methods Using automated data extraction methods, we conducted an investigation of electronic health records from psychiatric emergency service (PES) patients from January 1, 2012 to December 31, 2017 at a busy […]

Trauma exposure and suicidality in a pediatric emergency psychiatric population

Objectives: The increasing rates of depression and suicidality in children and adolescents are reflected in the increasing number of mental health-related visits to emergency departments. Despite the high rates of traumatic exposure experienced by high-acuity children and adolescents and a known link to suicidal ideation, the systematic review of trauma history is not a consistent part […]