The psychologist’s role in the emergency department

Abstract

Patients with psychiatric disorders pose a significant burden on emergency care. In response to this situation, since 2018 psychologists have been employed in the Department of Emergency Medicine (DEM), Jahn Ferenc South Pest Hospital to tackle this problem. In the subsequent 3 years following the implementation of frontline psychological services at the DEM , seven of the 8 psychologists employed at the DEM left this position.

To explore the reasons for the high rate of turnover of psychologists at the DEM, a questionnaire survey was conducted covering the attitudes and expectations of DEM staff towards the activity of psychologists.

The questionnaire was divided into three parts. The first part consisted of three questions on length of employment, position and frequency of working. The five questions of the second part asked about the tasks of the psychologists in general and in the Emergency Department in particular. In the third part respondents rated the importance of the psychologists’ contribution in 15 tasks such as evaluation and support of patients in crisis, conflict management, or physical restraint of aggressive patient or relative.

The response rate was 32%. The responses regarding specific tasks expected from psychologists mainly included the exploration of somatization complaints, communication with patients and providing them with information, thereby relieving medical and nursing staff. Respondents correctly identified the tasks not belonging to psychologists’ responsibility, while those evidently part of the psychologist’s duty were not regarded as particularly important. Tasks that could not be delayed or required immediate intervention were rated as of high priority.

Based on these results, it has to be reconsidered how to meet the needs of the DEM staff and whether employment of psychologists is the best solution for this purpose. Identification of patients with psychological or psychiatric problems and the provision of brief psychological interventions can be taught to non-psychologist staff members to deliver them under the supervision of psychologists. To meet patients’ psychological needs not requiring specific psychological interventions, an alternative solution could be the employment of mental health professionals, social workers or volunteers.