Emergency Mental Health
Alicia Burrows, Assistant Editor-In-Chief
This week marks the fifth week that I have been interning in the Emergency Mental Health (EMH) unit at UMASS Memorial Medical Center. As a Health Sciences major, I am required to do a 200-hour internship, and I could not have been happier with my choice to intern at UMASS. Going into the internship, I had no clue what I would be doing. I knew I would be able to see patients, but I didn’t know how often, or if the staff in EMH would let me talk to the patients.
Needless to say, I was pleasantly surprised. On the first day, my supervisor, DeAnna, was more than happy to introduce me to everyone who works in the unit and to take me with her to see patients. DeAnna is a LICSW, which stands for Licensed Independent Clinical Social Worker. Alongside DeAnna, there are nurses, psychiatrists and LMHCs (Licensed Mental Health Counselors) who have the same role in the department that she does. Basically, DeAnna’s role, and the role of the other social workers and counselors in EMH is to do crisis evaluations on people who come into the unit.
When patients come to EMH, it is usually because they are suicidal, have out of control behavior or were sent there by the police. Our job at EMH is to perform a crisis evaluation to determine if they are safe to go home, or if they need further levels of treatment (either in an inpatient psychiatric facility or at a day program). When a patient first comes to EMH, they meet with the nurse, who checks their vitals, any medications they are on and gets a brief synopsis of why they are there.
Next, a social worker or counselor will do an in-depth “interview” of the patient, where they gather patient and family mental health history, current health status, what reason/who brought them in, what providers they have (if any) and substance use history. After interviewing the patient, the counselor will meet with the patient’s parent (if the patient is a minor) or make a
phone call to someone close to him (parent, friend, significant other) if the patient is an adult. If the patient already sees a psychiatrist or therapist, phone calls will be made to them as well. Calling these “collaterals,” as they are referred to, helps the counselor get a bigger picture of the patient’s situation, and helps them to make a decision regarding the patient’s treatment.
Finally, after the counselor has collected all of this important information, she presents the case to the psychiatrist, and recommends the treatment options for the patient. Ultimately, the psychiatrist makes the final decision regarding the patient’s disposition, but the counselor and the psychiatrist work together to decide what is best for the patient. If the decision is for the patient to be discharged home, the counselor fills out paperwork and sends them on their way. If the decision is to be admitted to a facility, the counselor has to do a “bed search” to find outpatient facilities or hospitals that have an availability for a patient. Once the counselor finds a location for the patient to go, the patient is discharged and transferred there.
Finally, the counselor has to type up notes on the patient into the electronic medical records, which include the patient’s history, mental status exam, family history, substance abuse history, presenting concerns, summary/clinical formulation, diagnosis and treatment goals. Overall, being a social worker/counselor in EMH is a lot of work, but it is very rewarding to be able to help people through a crisis and give them the best care possible. I am very grateful to DeAnna and the rest of the staff at EMH for welcoming me to the team for the semester, and for giving me the independence to do much of the crisis intervention process myself.