What is it about?
We sought to better understand the lived experiences of Black patients presenting for evaluation in a locked psychiatric emergency unit. Our participants told us about experiences that made them feel criminalized, stigmatized and vulnerable. Our participants also expressed insight into the need for help, though they reported a mismatch between the help they hoped for and the help they received. Our participants also recognized specific helpful interventions. For individual patient interactions, we recommend a trauma-informed approach to individual patient care, with compassionate communication and clear updates regarding next steps in care. For the larger system, our findings underscore the need for interdisciplinary systemic changes to decriminalize and destigmatize the delivery of emergency psychiatric care with the overarching goal of achieving health equity.
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Why is it important?
A group of people whose feedback is infrequently considered in satisfaction surveys, Black individuals evaluated and treated in a locked psychiatric evaluation unit, provided useful information about their experiences and recommendations we can act on to improve. Our study brings attention to the need for systemic changes to decriminalize and destigmatize the delivery of emergency psychiatric care with the overarching goal of achieving health equity.
Perspectives
Having the opportunity to understand the lived experiences of patients experiencing intersectional adversity related to mental illness and racialized identity has facilitated my own practice with individual patients while motivating me to continue to advocate for systemic changes in the way we address psychiatric and behavioral healthcare. I am grateful to the individuals who participated so we could learn their observations and recommendations.
Jane Gagliardi
Read the Original
This page is a summary of: Experiences of Black Adults Evaluated in a Locked Psychiatric Emergency Unit: A Qualitative Study, Psychiatric Services, October 2023, American Psychiatric Association,
DOI: 10.1176/appi.ps.20220533.
You can read the full text:
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Association of Black Race With Physical and Chemical Restraint Use Among Patients Undergoing Emergency Psychiatric Evaluation
This study used electronic medical record data from 12,977 emergency department encounters to determine whether Black patients were more likely than their White counterparts to undergo physical and chemical restraint. Race was a significant predictor of physical and chemical restraint use for patients undergoing emergency psychiatric evaluation. Black patients receiving emergency psychiatric evaluation were more likely to undergo chemical and physical restraint compared with White patients.
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