In Crisis

We are in the midst of a mental health crisis that impacts our patients, our hospitals, the health care system, and our daily work in the emergency department. It is easy to be caught up in own experience, or the problems of our own department. But when we look beyond our hospital, we see that this is a huge crisis at county, state, and national levels. To help us understand why we are in this situation, and how we can work to improve things, we spoke with UC Davis’ Director of Emergency Psychiatry, Dr. Lorin Scher, and Emergency Physician and ED Director of Behavioral Health, Dr. Aimee Moulin. Here of some of their suggestions: The ED is often the only place patients in a mental health crisis have to go. These patients are suffering from serious, life threatening illness, and it is our job to care for them. Embrace it. Focus on patient centered care, including placing patients in an area where stimulation is minimized, away from doors, with mental health techs nearby, and employ early de-escalation strategies. Collaborate with psychiatrists, mental health professionals, and community partners. Consider implementing SMART clearance to minimize unnecessary blood draws and expedite treatment and placement in a psychiatric facility.  This problem is bigger than our EDs. Talk with your administrators, local government, connect with ACEP and other advocacy groups to amplify your voice. Advocate to  increase primary care mental health integration through collaborative care models. We can be a voice for our patients who don’t have a voice.  How is the mental health crisis impacting your department? Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  Subscribe and rate us on iTunes – it helps us reach more people!  ***Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** ***Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Lorin Scher, Associate Professor of Psychiatry, Director of Emergency Psychiatry at UC Davis, and Director of Integrated Behavioral Health Services in the UC Davis primary care network Dr. Aimee Moulin, Associate Professor of Emergency Medicine and ED Behavioral Health Director at UC Davis Resources: Sacramento has a mental health crisis. Let’s switch from ‘emergency’ to strategy.  By Dr. Lorin Scher, Special to The Sacramento Bee, May 5, 2019 California 5150 Law ACEP Mental Health Advocacy *** Dr. Lorin Scher Dr. Amiee Moulin Dr. Julia Magana Dr. Sarah Medeiros Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña and Isaiah Magaña at OM Audio Productions for audio production services.