Due to changes in the availability of our consulting psychiatry team we are implementing a modification in how psychiatry and behavioral health consultations are addressed on the medical floors at CHM and CHW. Starting November 1, 2014 psychiatrist coverage for consultations at CHM and CHW will be available Mondays through Fridays. For weekend and holiday coverage such consultations will be referred to the Centegra Behavioral Health Crisis Service for evaluation. A psychiatrist will always be available telephonically to provide support to the crisis workers; similarly, a psychiatrist will always be available via telephone to provide support to all Centegra Health System Medical Staff physicians/providers to address clinical matters on patients hospitalized at a Centegra facility. A call list will be sent out and the Care Coordination team, Crisis associates and operators will always know which psychiatrist is on-call.
We recognize this is a change from how things have been handled and look forward to collaborating with you to work through issues as they may arise. Crisis workers are not able to order laboratory/imaging studies or medications; this will require the cooperation of the ordering physician, again with support from the psychiatrist. The crisis associates will be able to evaluate risk/perform safety assessments, recommend aftercare and disposition options (including psychiatric hospitalization) and even assist with capacity determinations. If you feel that psychiatric medications are indicated call the on-call psychiatrist.
As a reminder, psychiatric consultation is appropriate for psychosis, altered mental status that is not clearing after thorough work-up for and treating organic causes, mania and patients with mental illnesses who are unstable. Patients being treated for acute alcohol withdrawal syndrome should not require a consultation if the available withdrawal protocol is initiated and followed appropriately. Please call with questions to help clarify how the psychiatrist can assist you:
Paul Berkowitz, MD