New Handbook for Psychiatric Emergencies to Help New and Seasoned Care Providers

ip_emergency_psychiatryOne of the most challenging clinical settings in psychiatry is in psychiatric emergency services. Taking care of patients who are acutely ill in a timely manner takes incredible skill and ability. Making the incorrect assessment can have life and death implications. In addition, family members are also very much part of the clinical situation and are often themselves frightened and worried.

Besides the seriousness of the clinical issues, first year and second year psychiatry residents working in psychiatric emergency departments are trying to quickly understand complicated clinical situations from patients in crisis, when their illness is at its worst. This makes for a very challenging situation indeed. Moreover, given how busy emergency departments can become,
trainees working in this very difficult and high-stress setting at times only have backup supervision rather than letting the supervisor conduct the majority of the evaluation and treatment personally.

This understanding of the complexities of psychiatric emergencies led U-M Depression Center members Michelle Riba, M.D., M.S. and Divy Ravindranath, M.D., M.S. to create the Clinical Manual of Emergency Psychiatry for trainees and clinicians. The handbook is intended to be easily read and highlighted. Each chapter was co-written by a trainee or junior faculty as well as a senior faculty member at several academic medical centers.

The authors chose topics which are generally the most important and practical in any busy psychiatric emergency department. Chapters are arranged by chief complaint, e.g. suicidal ideation, rather than by psychiatric diagnosis, e.g. major depression, because the emergency department is one of the few arenas where patients do not arrive β€œpre-labeled.” Case vignettes are also included in each chapter to contextualize the information provided and allow readers to envision the applicable clinical scenario even if they are not actively seeing patients in the emergency department setting. Also included are chapters on supervision and the role of medical students and teaching in the psychiatric emergency department. These chapters provide guidance for both supervisors, with regard to how to maximize the learning potential of the emergency department and for trainees, with regard to what to expect from their supervisors and how to maximize the supervision they receive.

This is not meant to be a textbook but rather a first pass at what care providers often confront when working in this type of setting. The hope of Drs. Riba and Ravindranath was to make this a very reader-friendly and useful handbook, reflecting widespread practices in various academic centers that can be read by trainees in many different disciplines.

The book can be purchased via book retail websites (e.g. or or from the American Psychiatric Publishing, Inc. where American Psychiatric Association members receive a members-only discount.

Authors can be contacted by e-mail:

Michelle Riba, M.D., M.S. –
Divy Ravindranath M.D., M.S. –