Beschreibung
Mental illness is ubiquitous and increasingly recognized as a growing problem throughout the world. The purpose of these chapters are to describe the magnitude of the problem of mental illness, both globally and in terms of specific mental-health-related visits encountered in emergency department (ED) settings. While emergency departments may not be the optimal location to manage the growing burden of mental illness, they generally constitute the only 24/7 access for the preponderance of patients in crisis. The global burden of mental illness supersedes that of all other diseases. Recent estimates place mental illness first in the proportion of both global years of life lost due to disability (YLDs; 32.4%) and in terms of disability-adjusted life years lost (DALYs; 13%). More conservative and somewhat incomplete metrics from WHO in 2013 suggested mental illness constituted only 21.2% and 7.1% of all global YLDs and DALYs, respectively. Escalation of mental illness is attributed to an increase in psychosocial and environmental stressors in many parts of the world, combined with the epiphenomenon of mental illnesses becoming less stigmatized in many advancing societies and patriarchal cultures. Indeed, a substantial increase in measured prevalence comes less from new biological challenges and much more from an increase in diagnoses; the latter diagnostic contagion has been generated in part by improved training and recognition, the proliferation of clinical psychologists, the widespread availability of structured diagnostic tools, and a penchant to pathologize symptoms formerly regarded as nonpsychiatric. Studies have shown that providers lack the expertise to care for these patients. These providers include emergency physicians, psychiatrists, nurses, social workers, pharmacists, and mental health workers. This text is intended to fill this knowledge gap. The second edition is updated, timely and focused to address this need by providing practical input from physicians experienced with adult emergency psychiatric patients. It covers the pre-hospital setting and advising on evidence-based practice; from collaborating with psychiatric colleagues to establishing a psychiatric service in your ED. Potential dilemmas when treating pregnant, geriatric or homeless patients with mental illness are discussed in detail, along with the more challenging behavioral diagnoses such as substance abuse, factitious and personality disorders, delirium, dementia, and PTSD. This go-to, comprehensive volume is invaluable for psychiatrists, psychologists, psychiatric and emergency department nurses, trainee and experienced emergency physicians, and other mental health workers.
Autorenporträt
Leslie S. Zun, MDRosalind Franklin University of Medicine and ScienceNorth Chicago, IL 60064 Michael P. WilsonUAMSPsychiatric Research Institute Little Rock, AR 72205 Kimberly Nordstrom, MDUniversity of Colorado School of MedicinePsychiatry Aurora, CO 80045
