Psychiatric Patient's triaged through ER?

[retro-active]

Is it very common to have a patient with a psychiatric problem, severe depression/ptsd from child abuse, to be told to go to the ER (at a covering hospital) to be triaged and how is the decision made to admit patient to inpatient psych through the hospital vs outpatient programs? Can the patient request inpatient if they have insurance? I work for the state so have almost free insurance.

[Daywalker]

At my facility, which includes a psych ward, patients are cleared through ER, then have a psych eval, conducted with psych RN, social worker and sometimes the Psychiatrist on call (depends on circumstances). Decisions to admit are based on medical need. If you are in need of help, call a crisis line and/or go to ER. The help is there for the asking.

[nuangel1, BSN, RN]

in my current hospital the psych clinician is a trained social worker .

[VaPsychRN]

At my hospital, almost all psych patients are triaged through the ER. Keep in mind that a psychiatric emergency is as important as a medical emergency -- without treatment, a psychiatric patient could be injured or die without intervention. I spent some time working an ER and realize that this is a difficult concept for trauma nurses to understand.

However, just because a patient wants to be admitted does not necessarily mean they should be. Other patients don't walk in and say "I'd like to be admitted to telemetry" and then we give them a bed. A psych patient must pose a danger to themselves or others through suicidal/homicidal ideation, poor judgement, poor impulse control, etc. A psych clinician can make that judgement; however some hospitals (like my own), that judgement is made by a ER doctor. If they have any hesitation, they call our county's mental health services or one of our physicians or nurses for a second opinion.