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Overview of Psychiatric Group Services

Comprehensive psychiatric group practices provide a full spectrum of hospital‑based and consultative services. These programs bring together psychiatrists, nurses, social workers, psychologists and other allied professionals to deliver evidence‑based, coordinated care across general hospitals, emergency departments and specialty units. A nationwide survey of general hospitals in the United States found that more than half of emergency departments and general hospitals lacked any specialty psychiatric services, underscoring the importance of integrated programs like those described here[1].

Emergency Room Psychiatric Evaluation

  • 24/7 or extended hours: Rapid assessment of psychiatric emergencies—including suicidality, agitation, psychosis and behavioral disturbances—is available around the clock or during extended hours in the emergency department[2][4].
  • Comprehensive evaluation: Clinicians perform risk assessments, obtain medical clearance, initiate pharmacologic therapy when needed and coordinate aftercare or disposition planning to ensure safe transitions[2][3].
  • Telepsychiatry options: To improve access and reduce wait times, some systems use a hub‑and‑spoke telepsychiatry model in which off‑site psychiatrists and on‑site nurse practitioners collaborate via videoconferencing to triage and treat emergency and inpatient consults[5].
  • Safety planning and brief interventions: Safety plans, lethal‑means counseling and brief interventions are incorporated as standard practice for high‑risk adults and youth to reduce recurrence of self‑harm or crisis presentations[4].

Inpatient Psychiatric Treatment

  • Acute stabilization: Inpatient units provide short‑term care focused on crisis management, patient safety and rapid initiation of individualized treatment plans for severe psychiatric illness[6].
  • Multidisciplinary team approach: Care is delivered by psychiatrists, nurses, social workers, therapists and other specialists. Subspecialty units (e.g., dual diagnosis, geriatrics or trauma) may be available to address specific populations[6].
  • Continuity and community integration: Treatment goals include measurable symptom improvement, planning for discharge and linkage with outpatient and community services to reduce recidivism and support recovery[6].

Substance Use Disorder Treatment

  • Integrated assessment and management: Psychiatric teams assess substance use disorders alongside psychiatric and medical conditions in emergency and inpatient settings, initiate withdrawal management or medication‑assisted treatment and coordinate care with medical teams[3][9].
  • Aftercare planning: Programs emphasize referral to outpatient or residential substance use services and address gaps in hospital‑based care through warm handoffs and follow‑up planning[3][9].

Consultation‑Liaison Psychiatry

  • Proactive and responsive consultation: C‑L psychiatrists and allied professionals work closely with medical and surgical teams to assess delirium, mood, anxiety and behavioral disturbances in medically ill inpatients. Early identification and management of psychiatric comorbidity improves outcomes, especially among older adults and patients with complex conditions[10][6].
  • Integrated service models: Proactive integrated C‑L services involve routine screening, early involvement in patient care and close collaboration with primary teams. Telepsychiatry can supplement in‑person consultation to provide timely expert input across multiple hospitals[5][11].
  • Multidisciplinary teams: C‑L teams may include psychiatrists, psychologists, advanced practice providers and social workers. They offer both in‑person and telepsychiatry consults to support trauma, surgical and medical teams in managing psychiatric aspects of complex cases[9][12].

Child and Adolescent Psychiatry

  • Specialized emergency care: Pediatric and adolescent psychiatric emergencies—such as suicidality, behavioral crises and acute mental health presentations—are assessed by specialized child and adolescent psychiatrists working alongside pediatric emergency teams[4].
  • Family‑centered approach: Clinicians collaborate with families and pediatric providers to ensure developmentally appropriate care and engage parents or guardians in treatment planning.
  • Safety planning and telepsychiatry: Safety plans, brief interventions and telepsychiatry are used to bridge resource gaps and facilitate access to care in underserved areas[4].

Transcranial Magnetic Stimulation (TMS)

Psychiatric groups may offer transcranial magnetic stimulation services for treatment‑resistant depression and other approved indications. TMS uses FDA‑cleared devices to deliver non‑invasive magnetic pulses to targeted brain regions. Patients are referred to TMS programs through hospital or outpatient teams, and treatment is coordinated with their existing mental health providers.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy is available for severe mood, psychotic or catatonic disorders when rapid symptom relief is required or when other treatments have failed. Both inpatient and outpatient ECT programs provide thorough medical clearance, anesthesia and post‑procedure monitoring to ensure safety.

Call Coverage

To support emergency departments, inpatient units and consultation‑liaison services, psychiatric groups provide 24/7 on‑call coverage. Structured handoff protocols and cross‑coverage communication ensure continuity of care across shifts and sites[2][10][3].

Additional Features

  • Multidisciplinary staffing: Teams include board‑certified psychiatrists, child and adolescent specialists, addiction psychiatrists, psychologists, advanced practice providers and licensed therapists[10][3][11][12].
  • Evidence‑based practice and quality improvement: Services emphasize evidence‑based care, continuous quality improvement and ongoing education for hospital staff to enhance psychiatric care across settings.
  • Flexible service models: Programs are tailored to each hospital’s needs, offering options such as 24/7 coverage, rapid response teams, outpatient liaison services and telepsychiatry to improve access and efficiency[10][5].

Collectively, these services aim to address the full continuum of psychiatric needs within hospital settings, reduce emergency department boarding and recidivism, and support integration of behavioral health into general medical care[1][10][2][3][11][12][4][6][7][8][9][5].

References

  1. Specialty Psychiatric Services in US Emergency Departments and General Hospitals: Results From a Nationwide Survey. Ellison AG, Jansen LAW, Nguyen F, et al. Mayo Clinic Proceedings. 2022;97(5):862‑870. doi:10.1016/j.mayocp.2021.10.025.:contentReference[oaicite:0]{index=0}:contentReference[oaicite:1]{index=1}
  2. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department. Nazarian DJ, Broder JS, Thiessen MEW, et al. Annals of Emergency Medicine. 2017;69(4):480‑498. doi:10.1016/j.annemergmed.2017.01.036.:contentReference[oaicite:2]{index=2}:contentReference[oaicite:3]{index=3}
  3. Organization and Function of Academic Psychiatric Emergency Services. Currier GW, Allen M. General Hospital Psychiatry. 2003;25(2):124‑129. doi:10.1016/S0163-8343(02)00287-6.
  4. The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. Saidinejad M, Duffy S, Wallin D, et al. Pediatrics. 2023;152(3):e2023063256. doi:10.1542/peds.2023-063256.:contentReference[oaicite:4]{index=4}:contentReference[oaicite:5]{index=5}
  5. Implementation of a Centralized Telepsychiatry Consult Service in a Multi-Hospital Metropolitan Health Care System: Challenges and Opportunities. Shayevitz C, Breitinger S, Lerario MP, et al. Journal of the Academy of Consultation‑Liaison Psychiatry. 2021;62(2):193‑200. doi:10.1016/j.psym.2020.08.002.:contentReference[oaicite:6]{index=6}:contentReference[oaicite:7]{index=7}:contentReference[oaicite:8]{index=8}
  6. The Crisis in Psychiatric Hospital Care: Changing the Model to Continuous, Integrative Behavioral Health Care. Clarke A, Glick ID. Psychiatric Services. 2020;71(2):165‑169. doi:10.1176/appi.ps.201900259.
  7. Acute Psychiatric Care: Approaches to Increasing the Range of Services and Improving Access and Quality of Care. Johnson S, Dalton‑Locke C, Baker J, et al. World Psychiatry. 2022;21(2):220‑236. doi:10.1002/wps.20962.:contentReference[oaicite:9]{index=9}:contentReference[oaicite:10]{index=10}
  8. Goals of Inpatient Treatment for Psychiatric Disorders. Sharfstein SS. Annual Review of Medicine. 2009;60:393‑403. doi:10.1146/annurev.med.60.042607.080257.
  9. Best Practices Guidelines: Screening and Intervention for Mental Health Disorders and Substance Use and Misuse in the Acute Trauma Patient. Brasel KJ, deRoon‑Cassini TA, Bernard A, et al. American College of Surgeons. 2022.:contentReference[oaicite:11]{index=11}
  10. Organisation and Delivery of Liaison Psychiatry Services in General Hospitals in England: Results of a National Survey. Walker A, Barrett JR, Lee W, et al. BMJ Open. 2018;8(8):e023091. doi:10.1136/bmjopen-2018-023091.
  11. Proactive Integrated Consultation-Liaison Psychiatry: A New Service Model for the Psychiatric Care of General Hospital Inpatients. Sharpe M, Toynbee M, Walker J. General Hospital Psychiatry. 2020;66:9‑15. doi:10.1016/j.genhosppsych.2020.06.005.
  12. Consultation-Liaison Psychiatric Service Delivery: Results From a European Study. Huyse FJ, Herzog T, Lobo A, et al. General Hospital Psychiatry. 2001;23(3):124‑132. doi:10.1016/S0163-8343(01)00139-6.

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