Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk and make disposition decisions in a fast-paced and potentially chaotic setting. Patients may be medically ill, agitated, intoxicated, or suicidal, and resources for treatment may be difficult to access. A Case-Based Approach to Emergency Psychiatry provides the emergency department clinician with vivid and complex cases, discussed by psychiatrists who work daily in the emergency setting, that illustrate basic principles of assessment, diagnosis and treatment. These challenging and complex cases are based on the years of experience of the authors combined with current evidence-based practices and discussion. Risk assessment, psychosis, mood disorder, substance abuse, ethics, forensic issues, and personality disorders are discussed, along with child and adolescent, geriatric, and developmental disabilities. Special attention is also paid to alternatives to inpatient care, short-term crisis intervention, and the interface between medical and psychiatric illnesses. The case-based format allows the authors to link aspects of the clinical presentation to discussion and literature review in a memorable and compelling format.

Written and edited by leading emergency psychiatrists, this is the first comprehensive text devoted to emergency psychiatry. The book blends the authors' clinical experience with evidence-based information, expert opinions, and American Psychiatric Association guidelines for emergency psychiatry. Case studies are used throughout to reinforce key clinical points. This text brings together relevant principles from many psychiatric subspecialties—community, consultation/liaison, psychotherapy, substance abuse, psychopharmacology, disaster, child, geriatric, administrative, forensic—as well as from emergency medicine, psychology, law, medical ethics, and public health policy. The emerging field of disaster psychiatry is also addressed. A companion Website offers instant access to the fully searchable text. (www.glickemergencypsychiatry.com)

In this issue of Emergency Medicine Clinics, guest editors Drs. Eileen F. Baker and Catherine A. Marco bring their considerable expertise to the topic of Psychiatric and Behavioral Emergencies. Top experts cover key topics such as the emergency psychiatric interview; the agitated patient; the suicidal or homicidal patient; excited delirium; substance use disorders; schizophrenia; depression; and more. Contains 15 relevant, practice-oriented topics including bipolar affective disorder; geriatric and pediatric psychiatric emergencies; personality disorders; malingering; legal and ethical considerations; and more. Provides in-depth clinical reviews on psychiatric and behavioral emergencies, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

"A 38-year-old married woman is brought to the emergency department by EMS. The EMTs report that she had been talking about having suicidal ideation and wanting to kill herself. She also complains of nausea and vomiting. You have been called to examine her. As you approach her stretcher, you notice that she has long, dark hair that looks matted and somewhat disheveled. She looks pale and is gripping a bowl. As you step to her side, she sits up, bends over the bowl and throws up liquid material, with a trace of bright red blood. You wait until she is done, and ask her: "Can I help you?" She looks at you for a split second and then puts her finger down her throat and induces vomiting. She then slides down on the stretcher, feet hanging off the edge and begins to moan. She does not answer, and does not look at you. You ask again: "You must feel very nauseous. Is there anything I can do to help you?" She barely looks at you, just groans, and once again puts her finger in her mouth to initiate the gag reflex. She hugs the bowl, throws up clear liquid, and continues to heave. She then turns away from you and stops responding to your offer to help"--

The second edition of Clinical Manual of Emergency Psychiatry is designed to help medical students, residents, and clinical faculty chart an appropriate course of treatment in a setting where an incorrect assessment can have life-or-death implications. Arranged by chief complaint rather than by psychiatric diagnosis, each chapter combines the fresh insights of an accomplished psychiatry trainee with the more seasoned viewpoint of a senior practitioner in the field, providing a richly integrated perspective on the challenges and rewards of caring for patients in the psychiatric emergency department. This newly revised edition presents current approaches to evaluation, treatment, and management of patients in crisis, including up-to-date guidelines on use of pharmacotherapy in the emergency setting; suicide risk assessment; evaluation of patients with abnormal mood, psychosis, acute anxiety, agitation, cognitive impairment, and/or substance-related emergencies; and care of children and adolescents. The editors have created an accessible text with many useful features: * A chapter devoted to effective strategies for teaching, mentoring, and supervision of trainees in the psychiatry emergency service.* Chapters focused on assessment of risk for violence in patients, determination of the need for seclusion or restraint, and navigation of the legal and ethical issues that arise in the emergency setting.* Clinical vignettes that contextualize the information provided, allowing readers to envision applicable clinical scenarios and thereby internalize important concepts more quickly* Constructive "take-home" points at the end of each chapter that summarize key information and caution against common clinical errors.* References and suggested readings to help readers pursue a deeper understanding of concepts and repair any gaps in knowledge. Emergency psychiatry is one of the most stressful and challenging areas of practice for the psychiatric clinician. The guidelines and strategies outlined in Clinical Manual of Emergency Psychiatry, Second Edition, will help psychiatric trainees and educators alike to make sense of the complex clinical situations they encounter and guide them to advance their skills as clinicians and educators.

This book documents the ways that clinical practitioners and trainees have used the “structural competency” framework to reduce inequalities in health. The essays describe on-the-ground ways that clinicians, educators, and activists craft structural interventions to enhance health outcomes, student learning, and community organizing around issues of social justice in health and healthcare. Each chapter of the book begins with a case study that illuminates a competency in reorienting clinical and public health practice toward community, institutional and policy level intervention based on alliances with social agencies, community organizations and policy makers. Written by authors who are trained in both clinical and social sciences, the chapters cover pedagogy in classrooms and clinics, community collaboration, innovative health promotion approaches in non-health sectors and in public policies, offering a view of effective care as structural intervention and a road map toward its implementation. Structural Competency in Mental Health and Medicine is a cutting-edge resource for psychiatrists, primary care physicians, addiction medicine specialists, emergency medicine specialists, nurses, social workers, public health practitioners, and other clinicians working toward equality in health.

A fascinating text that addresses the clinical and educational challenges of treating psychiatric patients from a truly multidisciplinary perspective using a case-based format, Approach to the Psychiatric Patient: Case-Based Essays is the only book of its kind and an indispensable addition to the mental health practitioner's library. The new edition builds upon the strengths that distinguished the first, with composite cases that are carefully constructed to capture real-world problems, followed by essays that provide clear and cogent perspectives on the case. These essays cover a wide range, from the more conventional (such as differential diagnosis of anxiety or the clinical characteristics of delirium) to the unusual and intriguing (such as creativity and mental illness or an analysis of the case in relation to the classic, Strange Case of Dr. Jekyll and Mr. Hyde). Every chapter has been revised, and the book boasts many new co-contributors, as well as the addition of completely new essays. For example, in the chapter on geriatric depression, several new essays have been added on the topics of collaborative care and the embedded psychiatrist, depression and medical illness, and biomarkers to identify depression subtypes, while the chapter on terminal illness features new essays on spirituality and meaning-centered therapy. In addition, there are new essays on co-occurring anxiety and alcohol use disorders, medication assisted treatment for stimulant use, treatment of body dysmorphic disorder, and more.The text possesses many useful attributes for the reader: The more than 100 essays were written by a broad range of specialists, each with particular expertise in their aspect of the case, and the resulting commentary is focused and concise. In addition to the case and discussions, each chapter offers an overview and summary points designed to facilitate further consideration of the patient and clinical situation and to focus on the key points. The book's unique structure enhances its flexibility, allowing the reader to read a case and accompanying essays straight through, or to pick and choose as the need or whim arises. The cases' clinical settings are diverse, ranging from inpatient hospitalizations and emergency room evaluations to outpatient assessments and long-term psychotherapies, maximizing relevance and resonance. Each essay has its own bibliography, which provides both rigorous documentation and additional sources for more exploration of the topic. Approach to the Psychiatric Patient: Case-Based Essays distinguishes itself from prior texts in both the richness of its cases and the ingenuity of its format, and its multidisciplinary wisdom and insight will be appreciated by a wide range of readers.