The gap between physical and mental healthcare is starting to be bridged thanks to a number of hospitals in the United States which are trying out a new pilot program. In the past, ‪psychiatrists‬ saw patients on medical units only as consultants, when called upon by other physicians after a mental health crisis emerged such as the development of ‪delirium‬ or when a patient becomes difficult to manage. However, with this new project, psychiatrists are an integral member of medical ward teams, including those in the ‪ICU‬.
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By including psychiatrists on these medical teams, they have the opportunity to round on all the patients on the unit, helping to identify and tackle mental or emotional health problems early on, provide bedside ‪psychotherapy‬ and support, and offering much needed input regarding medications and other modalities to use and avoid in order to prevent the development or worsening of ‪‎mental health‬ issues.

While the hospitals are currently studying the impact of this new program, early data has shown that by having psychiatrists on the medical wards length of stay in hospital can be shortened, and they further postulate that these new teams may even reduce the chance that patients may need to be readmitted.

For the full article, click here:
http://www.wsj.com/articles/hospitals-test-putting-psychiatrists-on-medical-wards-1461604767

Although delirium is a medical emergency, it is significantly under-recognized and under-treated by healthcare staff in hospitalized patients. It is especially common in ICU settings, previously being referred to as 'ICU psychosis', and in the elderly population. It is estimated that 40% of cases are preventable and the effects of delirium can persist long after discharge. "Research has linked delirium to a greater risk of falls, an increased probability of developing dementia, and an accelerated death rate." To read more about the importance of recognizing delirium in hospitalized patients check out this great article that recently appeared in The Atlantic:

http://www.theatlantic.com/health/archive/2015/06/the-overlooked-danger-of-delirium-in-hospitals/394829/
 

Delirium is an acute state of confusion that commonly affects older adults and often goes unrecognized by health care professionals. The DSM-5 diagnostic criteria for delirium include A) a disturbance in attention and awareness; B) the disturbance develops over a short period of time (hours to days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of the day; C) an additional disturbance in cognition (i.e. memory deficit, disorientation, language, visuospatial ability, or perception); D) the disturbances are not better explained by another neuro-cognitive disorder and do not occur int he context of a severely reduced level of arousal (i.e. coma); E) evidence from the history, physical exam, or laboratory findings that the disturbance is a direct physiological consequence of another medical condition, substances intoxication or withdrawal, or exposure to a toxin, or is due to multiple etiologies. 

Would you be able to recognize the presence of delirium in a patient? To find out more about this medical emergency visit  This is Not My Mom.