Also, why do EM people dislike psych stuff?
I do not enjoy treating psych patients for the following reasons:
The ER is the official dumping ground for any person "out in the world" who is acting crazy enough for an innocent bystander to call 911/police.
Every time someone gets high enough on crack/meth/etoh/benzos/opiates to lose rational thought process, these people are brought to the ED for "stabilization."
Stabilization involves figuring out why they're crazy (which is never something I can fix) and preventing them from harming myself or ED staff using chemical/physical restraints.
Often chemical restraints result in these people becoming even more verbally and physically abusive (because now they are more high) causing patients to be placed in seclusion, where now they bang on the door and scream at the top of their lungs for the next 3 days.
Psych patients lie to you intentionally and maliciously.
Psych patients have no funding, because no one at the state/federal level cares about mental health.
Psych patients rarely have insurance and often don't have family or friends who can care for them. Thus, no one will accept the patient, and they are stuck in the ED for 40+ hours, banging on doors, taking their clothes off, spitting on staff, physically assaulting nurses, singing in a tone-deaf fashion, and generally being complete ass-holes.
Adding to this, a large amount of people brought to the ED for "psych eval" actually have a Cluster B personality disorder rather than schizophrenia/psychosis. So these are essentially "unfix-able" people who are dinguses at baseline and were out stealing cars/assaulting people or whatever and do not have a treatable psychiatric illness.
Lastly, the majority of "psych patients" whom we baby sit for 40+ hours as they disrupt the ED shouting obscenities, assaulting staff, etc go via police to a "mental health hospital" where an overworked doesnt-give-a-%%%% psychiatrist takes 15 minutes to review the chart, speak with the patient, declare them "not suicidal or homicidal" and discharges them to the street where the patient then goes back into the world, acting bat-**** crazy in society until they are either arrested or sent back to the ER.