American College of Emergency Physicians

Mental Health & Substance Abuse Information Papers

Information and Resource Papers

Assessing Psychiatric Safety in Suicidal Emergency Department Patients
This paper provides a review of the assessment of suicidal emergency department patients and includes a legal and ethical perspective. Read the full paper

Between Emergency Department Visits: The Role of Harm Reduction Programs in Mitigating the Harms Associated with Injection Drug Use
This clinical review article examines the specific health complications of injection drug use and reviews the evidence base for 2 interventions effective in reducing morbidity and mortality related to drug injection, irrespective of the specific drug used, that are less well known and infrequently leveraged by emergency medicine clinicians: syringe service programs and supervised injection facilities. Read the full paper

Care of the Psychiatric Patient in the ED: A Review of the Literature
This paper provides an overview of the literature on psychiatric care in the ED and addresses the following topics: evaluation of psychiatric patients in the ED, medical clearance, best practices for reducing boarding, medical management, disposition, and community resources. Read the full paper

Medication Therapy for Psychiatric Crisis Events
There are numerous options for emergency department treatment for psychiatric crisis events. Included in this paper are a variety of (non-exhaustive) references to assist the emergency physician in medication choices, options, and considerations. Read the full paper

Practical Solutions to Boarding of Psychiatric Patients in the Emergency Department-Does Your Emergency Department Have a Psychiatric Boarding Problem?
Of the estimated 136 million emergency visits yearly, 5%, or nearly 7 million Americans, present to our emergency centers with a primary psychiatric emergency. Limited funding, limited resources, and patient placement difficulties have cumulated to the current crisis of mental health patients boarding in the emergency department. Read the full paper

Resources on Behavioral Crowding and Boarding in the Emergency Department
This psychiatric boarding toolkit provides resources to address patient handoff and frequency of evaluation, activities of daily living for the boarded patient, initiation of mental health treatment while boarding, and development of ED psychiatric observational medicine. Read the full paper

Suicide Contagion in Adolescents: The Role of the Emergency Department
The intent of the paper is to educate emergency physicians about this emergency public health issue. The paper provides information about the definition of suicide contagion, types of contagion, screening, risk reduction, and available resources. Read the full paper

Synthetic Drug Overdose
Synthetic drug overdose is a complex problem. Federal, state and local health officials have started to provide drug abuse data surveillance to healthcare providers to help with care. The most commonly used databases are provided. Read the full paper