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Imminent Risk to Self & Others

Assessing patients presenting with suicidal and/or homicidal ideation can be a difficult task even for seasoned behavioral health clinicians, and often a daunting one for other medical professionals not specifically trained in that area. 

Approximately one in five (20%) emergency department (EDs) visits in the United States present with primary psychiatric and substance use disorders, many with reports of thoughts to harm themselves and/or others.(1) This trend is only increasing. In just five years from 2007 through 2011, ED utilization by psychiatric patients increased by 15 percent.(2) 

Evaluating suicidal and homicidal risk requires special knowledge and training, and if done poorly can have enormous costs both in human lives and financial liability for the organization. 

TelePsych Supports has over 15 years of experience conducting imminent risk evaluations in hospitals, allied health clinics and correctional settings. Our doctors have an average of 10 years experience in the field of behavioral health assessment and treatment.  

Involuntary Commitment

A critical component of conducting imminent risk evaluations in a hospital or ED setting is understanding the role of Involuntary Commitments (IVC) in the evaluation process, and the nuance of navigating that in as humane a manner as possible. 

IVCs are a blunt instrument, but often required, as a means to ensure that a patient remains sufficiently safe and receives needed treatment for psychiatric stabilization. Although IVC is often a necessary option to avoid harm to self or others, it is important to be mindful that this process temporary restricts a patient's rights and independence. As such, it can be perceived as a frightening experience, requiring sound clinical judgment in its implementation, and tact in presenting this plan to the patient and his/her family. 

Beyond the clinical and technical skill set to employ IVCs, TelePsych Supports clinicians have extensive experience in navigating these delicate decisions and discussion with patients and their family members. This approach results in improved patient experience, buy-in and engagement in the commitment process by the patient and their family, and subsequent clinical outcomes. 

(1) Owens PL, Mutter R, Stocks C. Mental Health and Substance Abuse-Related Emergency Department Visits Among Adults, 2007. HCUP Statistical Brief #92. July 2010. U.S. Agency for Healthcare Research and Quality, Rockville, MD. 

(2) Agency for Healthcare Research and Quality. Chartbook on Care Coordination. Measures of Care Coordination: Preventable Emergency Department Visits. May 2015. Rockville, MD: Agency for Healthcare Research and Quality.

Crisis Evaluations