Emergency Psychiatry Services
Manager: Terry McGurk
Components of ServiceEmergency Room Triage and Emergency Psychiatric Assessment Unit (ER & EPAU)
The Psychiatric Emergency Service (PES) at St. Joseph's Hospital consist of the Emergency Psychiatry Team (EPT) and the Emergency Psychiatry Assessment Unit (EPAU). EPT and EPAU work together to provide compassionate care that respects the dignity and privacy of all persons receiving emergency psychiatric care.EPT refers to the clinicians and psychiatrists who assess and treat persons with acute mental health problems. It has been a city-wide program since 1992 and currently sees over 350 people each month. EPT only sees people who have been referred by an emergency room doctor or a family doctor. EPT provides training for many students in the health care professions. The staff in EPT work with clients to ensure they receive the most appropriate care.
The EPAU is a clinical unit exclusively for persons with mental health problems. It is part of the general emergency department. All persons in the EPAU are seen by the emergency room doctor. The nurses who provide the care for patients in this area have psychiatric expertise. How the PES Works
When people are in crisis and need a psychiatric assessment they are often distressed. The assessment can be time consuming and may be confusing. Here is a list of the usual steps in the process:
- When you arrive at St Joseph's Hospital, first you will see the triage nurse from the Hospital Emergency Service. The nurse will check your vital signs (blood pressure, temperature and pulse) and ask you some questions about the problem. The triage nurse will decide where you should sit while you wait to see the emergency room doctor. You may be directed to a medical treatment room, a room in the EPAU or the waiting room.
- You will be seen by the emergency room physician. The amount of time you will have to wait will depend on your specific needs and how busy the emergency room is. St. Joseph's Hospital has many student doctors working in the emergency room. If you are seen by a student doctor first you will then have to wait until the student doctor discusses your problem with the emergency room physician and the doctor comes to see you.
- The doctor may order some investigations such as blood work or an x-ray.
- The emergency room physician will decide if you need to be seen by EPT. Many people with mental health problems do not need to have a specialty assessment and can be discharged to be cared for by their therapist or family doctor. If the emergency room doctor feels you need a psychiatric assessment he/she will make a referral to the clinicians in EPT.
- The clinician or doctor from EPT will meet with you as soon as possible. As part of your assessment, the clinician or doctor will ask you many questions to try and understand your problem and how you are feeling.
- The clinician may ask your permission to contact members of your family, your family doctor or therapist, or another hospital where you have been treated in the past. Except in an emergency, your permission is need to do this. This information is an important part of the assessment.
- When the clinician has gathered all the information he/she will discuss your problems with the psychiatrist or senior resident in psychiatry.
- The psychiatrist or senior resident will then come to talk to you and may ask some additional questions.
- Once all the information has been gathered the clinician and doctor will meet with you to make a decision about what care we can offer. They may recommend that you come into hospital, that you go home with follow-up, or that you wait in the EPAU for further assessment.
- EPT will work with you to develop the best plan for you, however sometimes you may not agree completely with the final decision. At times people have to stay in hospital when they do not want to. The Mental Health Act permits this to happen for your safety.
If you have questions, please discuss them with any member of the team.
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COAST
Crisis Outreach and Support Team (COAST) - mobile crisis outreach service provided 24 hours a day, 7 days/week by a mental health worker and dedicated police officer from Hamilton Regional Police Service. COAST serves children, adolescents and adults and has established service agreements with a number of agencies, which provide community mental health services.Link: http://www.coasthamilton.ca/
