Helen Ross McNabb Center

Consultation Psychiatry within an Emergency Department Model

More than 10 percent of all emergency department patients in the United States present with psychiatric symptoms. While emergency department doctors are able to meet a patient’s acute medical needs, the departments oftentimes lack specialized psychiatric providers trained to give the needed care during a time of psychiatric crisis. When these patients require care in a behavioral health facility, but an inpatient bed is not immediately available, the patient is “boarded” in the emergency department until psychiatric care can be provided at a different facility.

One of the nation’s leading psychiatric emergency departments is located in Phoenix, Arizona. The Helen Ross McNabb Center (HRMC) is proposing to visit the Connections Crisis Urgent Psychiatric Care Center (UPC), a psychiatric emergency department, with the East Tennessee Children’s Hospital (ETCH) and the University of Tennessee Medical Center (UTMC), to research the Phoenix model and determine best practices to implement specialized psychiatric care in Knoxville-area emergency departments.

The proposed project will provide quality care for a person presenting to the emergency department in a psychiatric crisis. The Center would establish a psychiatrist and master’s level clinician to round at Knoxville-area emergency departments and provide consultation to the emergency department doctors. By partnering with local emergency departments, the team would be able to assess patients, provide medication consultation, establish crisis planning with patients and generally help stabilize the milieu at the emergency department. This project would provide better client care/outcomes, less boarding time for psychiatric patients in the emergency department, and diversion from inpatient psychiatric hospitalization.