ABSTRACT
This chapter discusses the administration of a system, pointing out unique clinical and management issues that may arise within the context of that service. Medical-surgical psychiatric emergencies differ from emergencies in an outpatient crisis clinic in three areas. First, patients who seek help in a crisis clinic or medical emergency department either initiate their own contacts or are brought to the clinic by family or friends. The relationship between patient and medical staff must be examined in all inpatient emergency psychiatric consultations, even though it may be a minor part of a problem that is overshadowed by the patient's acute psychiatric disorder. Inpatient emergency consultations usually require a high ratio of staff-to-patients because the psychiatric staff may have to travel to widely separated areas in the hospital to see patients. Psychiatric clinical specialists, psychologists, and psychiatric social workers are an integral part of staffing the emergency psychiatric service to the hospital wards.
