Adult Psychiatric Patient in the Emergency Department

Publication Date: January 1, 2017
Last Updated: March 14, 2022


Do not routinely order laboratory testing on patients with acute psychiatric symptoms. Use medical history, previous psychiatric diagnoses, and physician examination to guide testing. (C)

Use individual assessment of risk factors to guide brain imaging in the emergency department for patients with new-onset psychosis without focal neurologic deficit. (Consensus recommendation) (C)

In patients presenting to the emergency department with suicidal ideation, physicians should not use currently available risk-assessment tools in isolation to identify low-risk patients who are safe for discharge. The best approach to determine risk is an appropriate psychiatric assessment and good clinical judgment, taking patient, family, and community factors into account. (C)

Ketamine is one option for immediate sedation of the severely agitated patient who may be violent or aggressive. (Consensus recommendation) (C)

Recommendation Grading



Adult Psychiatric Patient in the Emergency Department

Authoring Organization

Publication Month/Year

January 1, 2017

Last Updated Month/Year

January 16, 2024

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Document Objectives

This clinical policy from the American College of Emergency Physicians addresses key issues for the diagnosis and management of adult psychiatric patients in the emergency department. 

Target Patient Population

Patients with psychiatric symptoms

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Emergency care

Intended Users

Paramedic emt, nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Management

Diseases/Conditions (MeSH)

D011570 - Psychiatry, D004635 - Emergency Medicine, D000296 - Adolescent Psychiatry, D004637 - Emergency Services, Psychiatric


emergency medicine, psyciatric, psychiatry

Source Citation

Ann Emerg Med. 2017;69:480-498.


Number of Source Documents
Literature Search Start Date
January 1, 2005
Literature Search End Date
September 3, 2015