ABSTRACT
In the emergency department setting a physician who is taking general medical calls may be asked to see a woman who looks bizarre and is shouting towards the ceiling as though she is responding to voices. Without standards, the physician may be trained insufficiently. A physical component to an emotional illness presentation may easily be missed. A patient's safety may be jeopardized. Slow response time may escalate a routine presentation. The guidelines for State Hospital Emergency Services would be similar to those for the general hospital, yet would emphasize close collaboration among the State Hospital, the local Community Mental Health Centers, and the local general hospital. The private psychiatric hospital emergency care guidelines would emphasize consultant availability, transfer agreements, and lines of authority. Each agency administrator should develop his/her own standards using those presented here as a means to identifying the important elements. Local constraints and practices then could be taken into account.
