MODULE 9: Behavioral Health (Under Review 10/9/23)

Module Presentation

Learning Objectives

  1. Demonstrate verbal de-escalation skills and early administration of voluntary medication in order to decrease potentially avoidable physical and chemical restraints in patients with mental health disorder

  2. Recognize disparities in access to care for patients with mental health and substance use disorders

  3. Identify interpersonal, institutional, and system-related factors possibly related to reported racial disparities in physical restraint use

  4. Implement knowledge of the interplay between social determinants of health and mental health disorders into bedside care

  5. Implement best practices for care for psychiatric patients boarding in the emergency department to ameliorate the effects of difficulty with access to care

  6. Implement trauma-informed-care practices in the care of emergency department patient, particularly those violently injured and with mental health disorders

  7. Identify evidence-based screening and referral practices for substance use disorders and implement effective SBIRT programs based in the ED 

  8. Develop a harm-reduction framework for assisting patients with substance use disorders in the ED

  9. Implement evidence-based and society-endorsed best practices for patients seeking treatment or at risk of complications for substance use disorders, including ED initiation/provision of medications for opioid use disorder in appropriate patients and effective connection to longitudinal treatment

  10. Identify unique needs among special populations with substance use disorder, including pediatrics, obstetrics, patients involved with the criminal justice system, and patients experiencing homelessness

Literature Review

Textbooks

  • Treatment of stimulant use disorder: A systematic review of reviews (10.1371/journal.pone.0234809)

  • Strategies for Alcohol Screening, Brief Intervention, and Referral to Treatment Sustainability in the Emergency Department (10.1097/TME.0000000000000311)

  • Alcohol screening and brief intervention in emergency departments: Review of the impact on healthcare costs and utilization (10.1016/j.jsat.2020.108096)

  • National survey of emergency department alcohol screening and intervention practices (10.1016/j.annemergmed.2010.03.004)

  • Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation (10.1177/2045125317753340)

  • Systematic Review of Clinician-Reported Barriers to Provision of Brief Advice for Alcohol Intake in Hospital Inpatient and Emergency Settings (10.1111/acer.14491)

  • Emergency department screening and interventions for substance use disorders (10.1186/s13722-018-0117-1)

  • Identifying the Assumptions and Bias That Affect Screening and Brief Interventions for Harmful Alcohol Use (10.1177/10783903211036494)

  • Emergency department screening and interventions for substance use disorders. (10.1186/s13722-018-0117-1)

  • Naloxone and Buprenorphine Prescribing Following US Emergency Department Visits for Suspected Opioid Overdose: August 2019 to April 2021. (10.1016/j.annemergmed.2021.10.005)

Paired Resources

Supplemental Materials

Sim cases/Case studies

Discussion guide for Best Practices and Access

Assessments

Questions