Sections
Context | Initial Evaluation and Differential Diagnosis | Rating Scales
Excerpt
The setting of the psychiatric assessment is important in that
it provides a context that defines the focus of the encounter and
therefore the content of the examination. For example, the assessment
of the depressed patient in the emergency room is very different
from the assessment of the depressed patient in the office, and
that is very different from the assessment within a general hospital
setting. The assessment of a depressed person in the emergency room
focuses on a rapid, yet thoughtful, determination of safety and
appropriate disposition—that is, does this person require
hospitalization or is treatment in a less restrictive environment
more appropriate? To expedite the determination of disposition in
the emergency room, the evaluation focuses on issues of safety,
suicidal thinking, future orientation, stability of social supports,
housing, and recent drug and alcohol use. This assessment should also
include a review of recent life events and potential precipitating
stressors. Collateral information from family, friends, and outside
physicians is helpful in determining the appropriate level of care.