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SJHH / Health Services/ Emergency Psychiatry Services

Emergency Psychiatry Services

What this program does...

The Psychiatric Emergency Service (PES) at St. Joseph's Healthcare Hamilton (SJHH) is located at the Charlton Campus. The PES team work to provide compassionate care that respects the dignity and privacy of all persons requiring emergency psychiatric assessment and intervention.

PES provides care by clinicians and psychiatrists who assess and treat persons with acute mental health problems who have presented to the Emergency Department at SJHH. It has been a city-wide program since 1992 and currently sees close to 600 people each month. PES provides training for many students in the health care profession. PES works in partnership with other inpatient and outpatient mental health services to assist individuals in finding the right level of care.

People experiencing a psychiatric crisis arrive in the emergency department in many different ways – either via ambulance, sometimes on their own, or because a loved one or support person brings them, and in some occasions, they are brought in by police officers. Hamilton Police Services (HPS) are a key partner in supporting emergency psychiatry care in Hamilton. With a common goal to provide the right support in the right environment to those in crisis in our community, we work with HPS to deliver innovative programs like St. Joseph’s Healthcare Hamilton’s COAST program. We have also implemented a process to reduce the stigma experienced by those accompanied by police in the department, as well as the time officers from HPS officers spend supporting patients brought to the Emergency Department. To learn more about the strategies in place to reduce HPS wait times in the ED, click here.

How this program helps...

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:

  1. When you arrive at SJHH, 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 problems you are experiencing. 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.
  2. The emergency room physician will see you. The amount of time you will have to wait will depend on your specific needs and how busy the emergency room is. SJHH has many student doctors working in the emergency room. If a student doctor sees you 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.
  3. The doctor may order some investigations such as blood work or an x-ray.
  4. The emergency room physician will decide if you need to be seen by PES. Many people with mental health problems do not need to have a specialty assessment and can therefore 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 PES.
  5. The clinician or doctor from PES 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.
  6. 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 needed to do this. This information is an important part of the assessment.
  7. When the clinician has gathered all the information he/she will discuss your problems with the psychiatrist or senior resident in psychiatry.
  8. The psychiatrist or senior resident will then come to talk to you and may ask some additional questions.
  9. 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 information, or that you wait in the EPAU for further assessment.
  10. PES 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.

True to the mission and values of SJHH please remember that at all times the members of the Emergency Psychiatry Team will do their best to provide quality, compassionate care to all of our patients.

If you have questions, please discuss them with any member of the team.

Crisis Outreach and Support Team (COAST)

The Crisis Outreach and Support Team (COAST) is a mobile crisis outreach service provided 24 hours a day, 7 days/week by a mental health worker and dedicated police officer from the 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.

Hamilton 24 Hour Crisis Line – 905-972-8338

Please click here for more information about the vital services COAST provides.

Family Resource Centre

Click here to access information about the Family Resource Centre at St. Joe's. 


St. Joseph’s Healthcare Hamilton
Psychiatric Emergency Services
Pam Johnston, Manager
Tel: 905-522-1155 Ext. 32197

Hamilton 24 Hour Crisis Line - 905-972-8338