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The psychiatrist is a medically trained MD who, in an ED setting, makes recommendations for psychiatric medications or can order them directly. Depending on the state where the ED is located, the psychiatrist may be able to place a patient on an involuntary psychiatric hold, compared with some states in which the ED MD is not able to place a patient on a hold.

Mental Health Therapists

Therapists are master’s- or doctoral- (PhD or PsyD) level clinicians who specialize in providing counseling and psychotherapy to a patient suffering from psychiatric disorders. They have similar abilities as the psychiatrist to treat a patient minus the ability to write medication orders. While a therapist may seem more attractive compared with a psychiatrist to an administrator due to lower staffing costs, experience and level of comfort working in an ED setting with a psychiatric population in crisis far outweighs any cost difference between the two roles.

The Security Team

The security team contributes by providing 24-hour supervision of the patient and acts as the eyes and ears of the ED treatment team. The security team is able to provide information for the treatment team on the patient’s daily behaviors and any visitors that have come and gone during their shift. Ongoing direct and consistent communication must take place between the security team and the rest of the ED team to ensure that all safety and patient need factors are accounted for.

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