THE PSYCHIATRIC EMERGENCY SERVICE:
WHERE WE’VE BEEN AND WHERE
Richard E. Breslow, M.D., Bonnie J. Erickson, R.N., and
Kathleen C. Cavanaugh, M.S.W.
The Psychiatric Emergency Service (PES) has evolved into a separate service
with its own space and staff specialized for the handling of psychiatric emergen-
cies. A study of trends in our PES reveals increased need for children’s services,
issues with managed care and an expansion in the use of the PES as a ﬁlter for
the mental health system in dealing with substance abuse. Education and re-
search have been added to the missions of the PES and there is strong potential
for future development in this area. PESs of the future may be very different,
with advances in communication, safety, computerized records and databases.
New dilemmas in balancing the patient’s right to conﬁdentiality and autonomy
against the potential of these advances are bound to occur.
The beginning of a new millennium is a good time to review where
we’ve been and where we’re going with respect to the Psychiatric
Emergency Service (PES). Twenty years ago Gerson and Bassuk (1)
Dr. Breslow is Clinical Associate Professor of Psychiatry, Albany Medical Col-
lege and Director of Crisis Services, Capital District Psychiatric Center. Ms.
Erickson is Assistant Director for Treatment Services, Capital District Psychiat-
ric Center. Ms. Cavanaugh is Program Director of Crisis Services, Capital Dis-
trict Psychiatric Center.
Address correspondence to Richard E. Breslow, M.D., Capital District Psychi-
atric Center, 75 New Scotland Avenue, Albany, New York 12208.
PSYCHIATRIC QUARTERLY, Vol. 71, No. 2, Summer 2000
0033-2720/00/0600-0101$18.00/0 2000 Human Sciences Press, Inc.