Violence against mental health professionals

One of the main points, I am sure somewhat resented by ER folks, is that psychiatric emergencies should be seen in the emergency room–not in a private office. There are multiple people there, IM sedatives, restraints, and usually security.

Patients at elevated risk of aggression should be seen in mental health centers or operationally similar clinics with the same advantages–a steel locked door, multiple personnel on site, and security. The institutional nature of the setting–the fact that it is less personal–also serves to diffuse the intensity of negative transference against any one person.

I find that some of my non-psychiatric colleagues think that the private practitioners are just being snobby or cherry-picking when they won’t take all referrals to their private when in fact they would be putting themselves, their patients, and staff at risk to do so. It is clinically bad management as some patients just shouldn’t be seen in that setting.