Possibilities and limits of multiprofessional attention in the care of psychiatric emergencies: analytical study

Abstract

Goal: To analyze the possibilities and limits of multiprofessional care in the attention to psychiatric emergencies. Method:It is an analytical study of the type integrative review of the comprehensive literature. Searches were conducted in the Latin American and Caribbean Literature (LILACS) and Nursing Database (BDENF) databases and in the ScieLo Virtual Library, with the use of Descriptors in Health Sciences (DECs): "Emergency Services, Psychiatric", "Forensic Psychiatry", "Psychiatric Rehabilitation", in the period from 2007 to 2017.Results: After data analysis, two thematic categories emerged: "Possibilities and limits in multiprofessional care for patients in crisis" and "The continuity of care to the patient in crisis by the multiprofessional team". The studies point out fragility in the management of the multiprofessional team of care to the patients in psychiatric crisis. Therefore, in the substitutive services to the psychiatric hospital, it is necessary IntroductionEmergency mental health situations refer to any disturbance of thinking, feelings or actions that require immediate intervention to protect the person or third parties from the risk of death. Among the most frequently encountered emergencies are suicidal behavior, aggressive behavior and disturbances in thinking and perception, with 20% of those assisted in emergency mental health services having suicide problems and 10% violent behavior [1].The violent and aggressive behavior expressed by the client denotes fear, anxiety and insecurity in those around him, including professionals. However, the culturally constructed fear of society towards all people in the psychiatric setting is disproportionate to the few that, in fact, constitute a risk to the social environment. Excessive fear in professionals may impair clinical judgment and lead to premature and large-scale use of sedative medications and physical restraints, such as bed restraints [1].Mental health emergencies are related to the various evolutionary and accidental crises related to human experience. But what specifies an emergency in mental health is the manifestation of behavior as a consequence of a situation in which the person is and for which his general performance is seriously impaired and the individual becomes incapable of assuming personal responsibilities [2].Emergency mental health refers to a situation of altered thinking (delirium) or actions (aggressive acts) that demand rapid care. These changes are associated with the risk of death, such as in suicide or in patients with violent behavior, or the situation of mental alterations resulting from the use of psychoactive substances or physical diseases, which must provide interventions for the reduction of sequelae. Thus, emergency is a set of contrasting emotional and practical interests, in which the patient and his/her crisis are only part and not the whole, and the health team must take into account all these possibilities at the time of evaluation [2].The approach to the person with mental disorder in an eme...