The Hamilton (McMaster) psychiatric network: the evolution of an integrated network of psychiatric services

Emergency psychiatry in the 21st century: critical issues for the future

Throughout decades of deinstitutionalization, the primary purpose of psychiatric emergency facilities has been defined as rapid referral of patients, triaging those who need 'emergent' care for their mental or emotional problems from those who do not. However, a merely triage-based conceptualization of the psychiatric emergency room does not take into account the ever increasing number of patients, the low accessibility of specialized services, the high need for early recognition of mental problems, or the need toward a more continuous provision of care. In this paper we aim to address some contemporary problems of emergency psychiatry, and then we try to outline some issues that may be of importance in the future of the psychiatric emergency room.

An integrated regional emergency psychiatry service

This paper presents a model of an integrated Psychiatric Emergency Service serving Hamilton, a community of 450,000 in Southern Ontario. It describes the evolution of the service and how it has integrated five separate, hospital-run Emergency Psychiatric Services into a single service. The principles of the service and ways in which it operates are outlined and the advantages and drawbacks of the model are discussed. The authors conclude that such a model leads to a more efficient use of resources and is adaptable to most urban communities with a similar, or even larger population.