aaep newsletter - spring, 2012
DESCRIPTION
AAEP Newsletter, March 2012 issue, springTRANSCRIPT
Inside this issue
Announcements .......................... 2
Empathy and Collaboration Better than Physical Restraint? .............. 3
Trauma, Therapeutic Engagement and Risk ...................................... 4-6
Behavioral Emergencies Seminars Update ........................................ 7
AAEP Goes to Philadelphia .......... 8
American Association For
Emergency Psychiatry
Newsletter Spring Issue 2012
Letter from the President
Dear AAEP Members,
I recall, as I advanced in medical school, having a difficult time deciding which specialty to
enter. I knew with my all-thumbs dexterity that surgery would be a bad call, but there
were plenty of other possibilities. Yet although there were strong points for several
fields, nothing seemed to reach out and grab me.
“Don’t worry,” a wise mentor told me. “Everyone finds their niche. You will too.”
And today I look back on 25 years in Emergency Psychiatry and think how prescient my
advisor was. I truly ended up finding what author Wallace Stegner describes as one’s
“Angle of Repose”; somehow I landed in a job that I love, that I still find exciting and
enjoyable, and where I feel I belong. I can honestly say I’ve never dreaded going to work
or counted the hours to the weekend as so many people do with their occupations. I
believe I am very lucky.
During my involvement with the American Association for Emergency Psychiatry, I have
met many wonderful people who also seem to revel in our unique profession. I have
made some outstanding friends-for-life, and have had the opportunity to mingle and
debate with talented and brilliant individuals. I think the practice of Emergency
Psychiatry attracts some of the most interesting, well-balanced, down-to-earth, and, dare
I say, nice and fun people of any medical discipline.
It has been my great privilege these past two years to serve as the President of our
organization, and I hope during that time that I have helped bring more of you great folk
together both educationally and socially. Project BETA, just published this month in the
Western Journal of Emergency Medicine, was a 16-month-long collaboration that was an
arduous, yet quite gratifying endeavor. The 35-plus of you created a fantastic six-article
product we can all be proud of, which I am certain will have a substantial influence on
the treatment of agitation for many years to come.
These two years have also seen us become a major presence at both the APA and IPS
conferences, where along with numerous scholarly presentations we have had great
group tours and social events. We also participated in the development of Dr. Leslie Zun’s
Behavioral Emergencies conferences, which are well on their way to becoming essential
annual events for both Emergency Medicine and Psychiatry.
One thing that has been wonderful to see the past two years is the involvement of more
(Continued on page 2)
Scott L. Zeller, MD
President 2010-2012
and more members in different aspects of the AAEP. Besides BETA, AAEP members have
been involved in writing guidelines for medical clearance; contributed to the rebirth of the
AAEP journal, Emergency Psychiatry; produced chapters for a new textbook on behavioral
emergencies; worked on developing a Centers of Excellence recognition for crisis
programs; and much more. Also, with our AAEP listserve, it now only takes a quick email to
connect with many of your AAEP colleagues to have your pressing questions answered, or
to politely argue any Emergency Psychiatry topic. Truly a lot to receive for your reasonable
dues amount (remember to remit soon if you haven’t yet!)
And now, as my term as your President comes to an end, I feel very optimistic about the
future of the AAEP. Our membership is growing both in numbers and via influence in
publications and presentations. We have collaborations developing with many other
specialty organizations and political entities. And we should have a terrific meeting in
Philadelphia in May, when among other AAEP events I will have the honor of passing the
gavel to incoming President Dr. Seth Powsner.
These past two years have been a wonderful experience for me, with great memories I will
always treasure. I do hope to be involved in other ways with the AAEP for as long as you
will have me.
And if any of you ever happen to visit the Bay Area, please look me up; I should be easy to
find. Just look for the guy smiling on his way to work, happy he found his niche, anticipating
all he can do that day to help his patients in the fascinating practice of Emergency
Psychiatry.
Scott Zeller, MD President
Letter from the President (continued)
2
AAEP Member Announcements
What’s going on with your
Emergency Psychiatry facility, with
you and your staff? We’d like to
know and share it with other AAEP
members in our informal
newsletter. Has your program
moved to a new building? Did you
or one of your attendings publish
an article related to Emergency
Psychiatry? Have you, your staff, or
your program recently been
honored? Is there a new
educational or training process you
are using that you believe could
help your peers? We welcome you
to share any news relevant to
Emergency Psychiatry with your
fellow members. Please send your
announcements to us either by
email or see the attached
Announcement Form and send
your news to:
AAEP Member Announcements
Project BETA makes headline news… again!
Treating Agitation in ER Requires Delicate Balancing Act
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=181069
http://alert.psychiatricnews.org/2012/01/treating-agitation-in-emergency-room.html
Acadia Hospital Appoints New Chief Medical Officer - Anthony Ng, MD
http://www.acadiahospital.org/news.aspx?id=91693
AAEP Journal, Emergency Psychiatry, article featured on AABH website:
Partial Hospitalization Programs as a Resource to Reduce the Overload in Psychiatric
Emergency Services
http://www.aabh.org/content/partial-hospitalization-programs-resource-reduce-
overload-psychiatric-emergency-services Send your announcements to
3
Upcoming Events
American Psychiatric Association
165th Annual Meeting
May 5-9, 2012
Philadelphia, PA
Emergency Psychiatry Seminar:
Theory to Practice
Monday, May 7, 2012
8:00 a.m.—12 noon
Philadelphia Marriott Hotel
Grand Ballroom Salon D
AAEP Social Event
Site Visit
Monday, May 7, 2012
Evening (Exact Time TBD)
Temple University CRC
Reception & Annual Business
Meeting
Monday, May 7, 2012
Evening (Exact Time TBD)
Location TBD
Institute on Psychiatric Services
October 4-7, 2012
New York, NY
Third Annual National Update on
Behavioral Emergencies
December 5 - 7, 2012
Flamingo Las Vegas Hotel
Have you paid your 2012 Dues?
Go to
www.EmergencyPsychiatry.org
today to remit your membership
dues payment online using a Visa or
MasterCard
Or mail payment to:
AAEP
One Regency Drive
P.O. Box 30
Bloomfield, CT 06002
Need an invoice? Contact the AAEP
Office at 888-945-5430 or email
request a copy.
Empathy and Collaboration Better Than Physical Restraints? New Treatment Guidelines Find Patient-Centered Interventions Best to Treat Violently Agitated Mentally Ill Patients, Could Revolutionize Emergency Care Approximately 1.7 million patients are admitted to U.S. emergency rooms each year for
episodes of agitation – where patients may become hostile, threatening and over-energized.
Until now, many medical centers have typically relied on the use of dangerous, coercive force
to restrain patients by tying their arms and legs to beds and then, against the patients’ will,
injecting them with powerful sedatives. Injuries to both patients and staff are common.
But through research and clinical experience, members of the American Association for
Emergency Psychiatry (AAEP) have found that by using verbal de—escalation techniques,
agitated patients could frequently be calmed to a level of cooperative collaboration, and
engage in their treatment willingly. Such an approach has led to dramatic reduction in injuries,
reduced hospital stays, and improved long-term outcomes for individuals – a win-win paradigm
for agitation – while often taking much less time than the traditional restrain-and-sedate
episode.
The research has culminated in Project BETA (Best practices in Evaluation and Treatment of
Agitation). After 16 months, this multidisciplinary effort has produced ground-breaking new
guidelines addressing all facets of the agitation spectrum, and is today published online in a
respected, peer-reviewed journal with free access to all.
Project BETA is composed of six related articles published in the February quarterly issue of the
Western Journal of Emergency Medicine. The articles address the following topics.
Overview of Agitation and Project BETA
Medical evaluation and triage of the agitated patient
Psychiatric evaluation of the agitated patient
Verbal de-escalation of the agitated patient
Psychopharmacologic approaches to agitation
Use and avoidance of seclusion and restraint
Project BETA is now published online by the Western Journal of Emergency Medicine and can
be found at: http://escholarship.org/uc/uciem_westjem?volume=13;issue=1
Additional background information on Project BETA during its formative stages, with examples
of agitated patients and the novel interventions, was published in Emergency Medicine News,
February 2011: http://journals.lww.com/em-news/Fulltext/2011/02000/
Special_Report__Project_BETA_Stresses_Verbal.2.aspx
The American Association for Emergency Psychiatry sees the publication of the Project BETA
articles as a potential landmark in the treatment of severe mental illnesses. AAEP believes that
BETA will lead to a new era of compassionate, collaborative care with agitated individuals.
AAEP President and Project BETA founder Scott Zeller, MD is available for interviews and
further information about the project including personal anecdotes about agitation; other
BETA participants are pleased to speak to the press as well. Please contact the AAEP offices as
noted above for prompt assistance via telephone or email.
At the outset, it is useful to remind ourselves of the overarching clinical strategy of psychiatric emergency work, which is that of turning acute patients into outpatients, or rather, helping acute patients to become outpatients. This orientation toward a clear goal, along with the shift in emphasis to include patient collaboration, focuses our efforts not only on the fundamental tasks of ameliorating acute dangerousness and symptoms of acute psychiatric illness, but also on the importance of engaging patients in treatment, with the ultimate goal of their participating constructively in outpatient care. As early as 1984, Bengelsdorf et al underscored the importance of factoring in the degree of therapeutic alliance when triaging a crisis patient to either an outpatient or inpatient care setting (1).
These three tasks correspond exactly to the three criteria of an appropriate mental health detention: 1) a diagnosable condition or illness, 2) a severity of illness that results in dangerousness or inability to care for self, and 3) an unwillingness to engage voluntarily in evaluation or treatment. (To allow for a slight broadening of the criteria, many practitioners would add that there are situations where the risk of a cooperative individual is so high that he or she may not be safely treated on a voluntary basis).
It is worth thinking through the logic of delimiting or circumscribing detentions in this way. If a patient willingly seeks outpatient treatment for schizophrenia, we rarely think about hospitalization if he isn’t in danger. If a decompensation of his illness does cause him to be at significant risk for harming himself or others, detention is not our first thought if he is quite willing to receive care in a 24-hour treatment setting on a voluntary basis. It is only when he is very ill, high risk, and declining to accept appropriate treatment, that we need to invoke involuntary treatment law. Therefore, when an individual is brought to a Psychiatric Emergency Service or Emergency Department on a mental health hold, it is not surprising that we often find it necessary to analyze in detail his reluctance to engage in treatment. Excluding ambulatory care cases due to poor access to treatment in the community, and excluding cases that are emergencies because of a sudden onset of illness that catches an individual by surprise, PES’s and ED’s are continually seeing individuals who suffer from an impairment of engagement.
Rarely are the emergencies that we encounter completely better after a one-time intervention. Our perennial challenge is to form a temporary but clinically useful relationship for the purposes of crisis intervention, to be followed by disengagement and a successful community referral. I am increasingly persuaded that this is a crucial but frequently neglected aspect of emergency care, and I am finding that the prevalence of patient trauma histories is very significant in this regard. A successful exploration of the problems a person has with the idea of treatment often uncovers maladaptive responses to trauma, provides the opportunity to mitigate them, and improves the chances of that person making an outpatient connection. Conversely, a failure to explore the hesitancy to engage in treatment reduces the likelihood that a person will seek out treatment after discharge. Certainly, trauma is not the only source of therapeutic resistance, but I am coming to believe that the recent emphasis on “trauma informed care” is well justified. (2)
Currently, my main evidence for this is seeing firsthand how positively an individual is affected when I take a brief trauma history and analyze how it may have impacted his or her engagement with mental health professionals in the past. Has engagement failed, been hampered, or been avoided altogether? I also make it a practice to assess how the person feels talking to me and to correlate this with how I feel talking to them. Inevitably, asking a patient at appropriate moments how it feels to be in the room with us gives us the chance to dispel fears and misconceptions. I first learned to do this in my residency from the late Brandt Steele, a gifted analyst and psychiatrist who pioneered the psychotherapeutic treatment of adults who had abused children and also usually been
(Continued on page 5)
Trauma, Therapeutic Engagement and Risk By: Jon Berlin, MD
4
Interested in writing for the Newsletter?
All members of AAEP are invited to
submit articles for publication the
Newsletter. We welcome articles
relevant to the field of Emergency
Psychiatry from all perspectives:
from psychiatrists working in a PES
to social workers, nurses, students,
or physicians in the field.
Newsletters are sent to the
Membership electronically on a
quarterly basis.
For deadlines and additional
information on how you can
contribute to the Newsletter,
please contact Jacquilyn Davis at
888-945-5430 or email
The three criteria of an appropriate mental health detention:
1. a diagnosable condition or illness,
2. a severity of illness that results in dangerousness or inability to care for self, and
3. an unwillingness to engage voluntarily in evaluation or treatment
5
victims of childhood abuse themselves. (3) He taught generations of clinicians at the University of Colorado Health Sciences Center and the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect to explain to an abuse victim that they will do everything in their power to be helpful, and they will never intentionally say or do anything to make him or her uncomfortable, but if they do so inadvertently, it is important for the patient to speak up.
The experience of witnessing increased engagement from using this approach in the course of a single, succinct evaluation session has been repeated many times in the Milwaukee County Psychiatric Crisis Service, where I personally treated several thousand emergency patients and supervised the treatment of many more over a 15-year period. I also took a certain number of these cases into my office practice and have followed them there. My thoughts about the importance of the therapeutic alliance have been influenced by the psychoanalytic literature on this subject (4, 5, 6, 7); the literature on the closely related concept of engagement (8); committee and conference work with members of the consumer community; three decades of clinical experience across the spectrum of care; and by being the medical director of an inpatient adolescent unit, where analysis of resistance to the therapeutic alliance and distrust of adults was the sine qua non of successful care. Donald Rinsley’s book, Treatment of the Severely Disturbed Adolescent (9), is a seminal work on these issues that is equally useful with many adult patients.
An articulate and mature-for-age 27 year-old woman on a hospital medical service was seen in psychiatric consultation for co-morbid anxiety, depression and concern about her suicide potential. Her primary care physician functioned as her hospital attending. She had held long conversations with him on his rounds the past two days. She was experiencing significant current psychosocial stressors, and had broken down crying about them several times. She liked talking and could always regain her composure eventually, but he was unsure whether talking to her was helpful and whether he had ordered the correct antidepressant medication. He was also concerned about the current relevance of a remote history of a major suicide attempt.
When I saw her, I was struck by her forthrightness, self-awareness, and resilience. Her parents had been physically abusive and heavily involved in an ideologically right wing political sect that espoused violence. She had escaped from the home in late adolescence, put herself through college, and married well. She had not lost the ability to work or care for her children, but she knew she had a recurrent major depression that needed treatment. She had much to live for, and reported only passive thoughts about death on occasion. She was also anxious to continue with me the conversations she had had with her attending, and I had the distinct impression that she would make an excellent outpatient. But, to my surprise, when I began to discuss a community referral, her demeanor changed and she became oddly non-committal about it. She knew that I was unavailable to continue seeing her after this visit, and I had the feeling that something else was affecting her.
I explored her past experiences of treatment. Medication management had been helpful for previous episodes of affective illness, but past therapists, she noted, always wanted to talk about her trauma. She agreed with their assessment that trauma was, as she put it, “probably at the root of all my problems”, but therapy didn’t work for her. I asked her what happened. She explained that whenever trauma came up in sessions, she would invariably dissociate to the point of seeing the therapist’s mouth move, but literally not hearing anything being said. I reassured her that therapy could focus on the current life stressors that troubled and overwhelmed her. She obviously wanted to talk about these things, and her medical treatment wouldn’t take long enough to finish this psychological
(Continued on page 6)
Trauma, Therapeutic Engagement and Risk (continued)
“As authority figures, we are constantly at risk for being the object of a
negative therapeutic reaction with patients
who have been mistreated or
disappointed by authority figures
in the past.”
work in the hospital.
It might be true that she would ultimately need to work through her trauma history, I explained, but it should be completely at her own speed. If a therapist broached the subject prematurely, she needed to speak up. A good therapist would recognize his error and completely respect her wishes. She hadn’t known this before, but it made sense to her. At this point, she felt much more comfortable accepting a referral, and I felt the consultation had also had the effect of enhancing a key dynamic protective factor against self-harm, that of engagement.
I did not see a need to address it directly, but this young woman may also have experienced my disengagement as an abandonment like that which she had experienced when she was being physically abused as a child and no one came to her rescue. She had a very positive response to the interview, and I had questions about the advisability of touching on these negative feelings at this juncture.
However, it occurred to me later that I had overlooked another important connection between trauma and her impaired therapeutic engagement. Some of this woman’s maturity was the kind of pseudo-maturity we see in resilient individuals who have broken away from seriously flawed parents and fostered in themselves an excessive independence. They have often done well in life but failed to progress to the next stage of maturity which is healthy interdependence, making it difficult for them to accept help when they were in crisis.
In the therapy setting, the usual dynamic is that talking about past trauma re-stimulates feelings of danger, dependency and vulnerability, and trauma victims don’t feel safe with the therapist. Unconsciously, they fear that the therapist will symbolically, or actually, re-traumatize them. In-depth trauma work should not commence until alliance and negative affect tolerance have progressed to the stage where the patient can tolerate the regressive pull of reactivating a paranoid transference. However, in getting started with a new person, it can be extremely liberating for the evaluator or therapist to outline these issues in a matter-of-fact way with the patient. This is why Brandt Steele’s approach was so successful.
The busy emergency practitioner has to pick and choose what areas to explore very carefully. As authority figures, we are constantly at risk for being the object of a negative therapeutic reaction with patients who have been mistreated or disappointed by authority figures in the past. In my experience, touching briefly on past traumas and their possible impact on engagement and the therapeutic alliance is not regressive and, in fact, is well worth the effort. It puts the individual at ease, allows for corrections of any misperceptions, clears obstacles to engagement, educates the patient about the appropriate role of trauma work in outpatient psychotherapy, and empowers the patient to take a more active role in their own treatment. Clinical experience teaches us that a strong alliance can make possible outpatient treatment of fairly high degrees of suicidal risk. These objectives therefore have considerable value in the emergency setting when focusing on the treatment ultimate agenda of treatment, that of helping an acute patient—especially an involuntary patient—to become a successful outpatient.
Trauma, Therapeutic Engagement and Risk (continued)
6
References
Bengelsdorf H, Levy LE, Emerson RL, et al. A crisis triage rating scale: brief dispositional assess-ment of patients at risk for hospi-talization. Journal of Nervous and Mental Disease. 172:424-430. 1984.
http://www.samhsa.gov/nctic/trauma.asp National Center for Trauma Informed Care. Accessed February 29, 2012.
Steele BF. Working with Abusive Parents from a Psychiatric Point of View. http://www.eric.ed.gov/contentdelivery/servlet/ERICServlet?accno=ED119405 National Center for Child Abuse and Neglect, Superintendent of Documents, U.S. Government Printing Office, Washington D.C., 1975.
Sterba, R. The fate of the ego in analytic therapy. International Journal of Psychoanalysis, 15, 117—126. 1934.
Greenson, Ralph R. (1965). The working alliance and the transfer-ence neurosis. Psychoanalytic Quarterly, 34, 155-181.
Gabbard GO. Psychodynamic Psychiatry in Clinical Practice. 4th ed. Washington, DC:American Psychiatric Publishing; 2005.
Adler G. The myth of the alliance with borderline patients. Am J Psychiatry. 1979;136(5):642–645.
Diamond RJ, Scheifler PL. Treat-ment Collaboration. New York: WW Norton, 2007
Rinsley DB. Treatment of the Se-verely Disturbed Adolescent. New York: Jason Aronson, 1983.
Members-only Listserv
AAEP has recently created a listserv
discussion group that is available via
invitation to members in good
standing only. This will be a great
opportunity to discuss pressing
issues, diagnostic dilemmas and
treatment approaches in Emergency
Psychiatry, and obtain consultation
from your fellow experts on difficult
cases. Please accept the invitation
and join us today!
There is nothing to fear, it will be
very easy to unsubscribe if you
choose to do so at a later time.
If you have misplaced or did not
received your invitation email, please
contact Jacquilyn Davis at:
7
The Sinai Health System in collaboration with Rosalind Franklin University of Medicine and Science/Chicago Medical School is presenting the “Third Annual National Update on Behavioral Emergencies” on December 5th through 7th at the Flamingo Las Vegas Hotel. This is the only conference in the country to
address the behavioral emergencies in the acute care setting including emergency department and PESs.
The purpose of this conference is to increase the knowledge and collaboration among care givers in the emergency, PES and acute care settings for patients who present with psychiatric symptoms. The target audience includes emergency physicians, psychiatrists, psychologists, nurses, nurse practitioners, mental health workers, social workers, and physician assistants.
There is an impressive array of presentations and speakers this year. The titles of this year’s presentations include Psychiatric Boarders in the Emergency Department, Pediatric Emergency Psychiatric Issues, Behavioral Aspects of Head Trauma, New Drugs of Abuse, Disaster Psychology, Transfer and EMTALA Regulations, Difficult Patient Presentations, Recovery and Self-Management, Eating Disorder and Use of Ketamine in the ED. The speakers are national and international experts in the field.
This year’s conference has many enhancements from last year. In order to ensure that all the pertinent topics are included in the conference, we have added a new pre-conference session in the afternoon on the basics to complement the competency examination. The second pre-conference session sponsored by the Institute for Behavioral Healthcare Improvement is an all day seminar on Systems Change for Better Emergency Department Care for Behavioral Health Clients is scheduled the day before the conference on December 5th. This workshop will provide methods for evaluating and improving the current system of care for behavioral health clients in emergency departments and examples of successful improvement projects at selected hospitals.
For those interested in the scientific paper session, investigators are invited to submit an abstract of original research in the area of behavioral emergencies such as the evaluation and treatment of psychiatric patients in the emergency setting. The abstracts must not have been presented elsewhere, limited to 300 words and need to be in a format that includes title, objectives, methods, results, and conclusion. The scientific committee composed of psychiatrists and emergency physicians encourages submission from residents in emergency medicine and psychiatric training programs. The deadline for submission is October 1, 2012 and should be emailed to Dr. Leslie Zun at [email protected].
Please join us for this exciting conference. For more information regarding the conference, go to www.behavioralemergencies.com or contact Trena Burke, conference coordinator at 1-773-257-6589 or [email protected]. For additional information regarding the IBHI pre-conference seminar, please contact Peter Brown at [email protected] or at 518 732-7178.
Behavioral Emergencies Seminars Update By: Leslie Zun, M.D.
Call for Abstracts
3rd Annual National Update
on Behavioral Emergencies
Conference
Las Vegas
December 5-7, 2012
Contact Dr Zun at [email protected]
Call for Abstracts
3rd Annual National Update
on Behavioral Emergencies
Conference
Las Vegas
December 5-7, 2012
Contact Dr Zun at [email protected]
Call for Abstracts Third Annual National Update
on Behavioral Emergencies
Conference
December 5-7, 2012
Flamingo Las Vegas Hotel
Investigators are invited to submit an abstract of original research in
the area of behavioral emergencies such as the
evaluation and treatment of psychiatric patients in the
emergency setting. The abstracts must not have been presented
elsewhere, limited to 300 words and need to be in a format that
includes title, objectives, methods, results, and conclusion. The
scientific committee composed of psychiatrists and emergency
physicians encourages submission from residents in emergency
medicine and psychiatric training programs.
Deadline - October 1, 2012
Email to Dr. Leslie Zun at [email protected]
AAEP Board Roster
President
Scott Zeller, MD
President-Elect
Seth Powsner, MD
Immediate Past President
Anthony Ng, MD
Board of Directors:
Leslie Zun, MD, MBA
Jagoda Pasic, MD, PhD
Daryl Knox, MD
Rachel Glick, MD
Social Work Liaison:
Janet Richmond, MSW
Past President - 2006-2008:
Avrim Fishkind, MD
Past President - 2004-2006:
Jon Berlin, MD
AAEP Executive Office Staff:
Executive Director
Jacquelyn Coleman, CAE
Administrative Assistant
Jacquilyn Davis
American Association for Emergency Psychiatry One Regency Drive
P.O. Box 30 Bloomfield, CT 06002 Phone: 888-945-5430
Fax: 860-286-0787 Email: [email protected]
Website: www.EmergencyPsychiatry.org
AAEP Goes to Philadelphia The American Association of Emergency Psychiatry (AAEP) will be attending the 165th
Annual Meeting of the American Psychiatric Association (APA). Join us on Monday, May
7th for a full day of AAEP events. From 8:00 am—12 noon, Faculty members Scott
Zeller, Jon Berlin, Rachel Glick, Seth Powsner and Leslie Zun will present Emergency
Psychiatry: Theory to Practice. This comprehensive session is a revision of the Seminar
presented at last year’s Annual Meeting. Beginning with a brief historical overview, the
Seminar will include in-depth talks on the emergency psychiatric evaluation,
management of agitation, risk assessment, medical evaluation of the psychiatric
emergency patient, and disposition/legal issues. The session will include case
presentations and time for questions/answers and discussion. To register for this event,
please visit the APA’s website at www.psych.org/annualmeeting.
Following the Seminar, Members of the AAEP Board of Directors will meet at the Loews
Philadelphia Hotel for a Board Meeting. If you have any items you’d like placed on the
agenda, please contact the AAEP Executive Office.
The Annual Social Event and Business Meeting will begin at 5:00 pm at the Temple
University Crisis Response Center located at the Episcopal Campus, 100 E. Leigh Ave.,
Philadelphia, PA. Following the Site Visit, members will travel to a local venue for a
casual reception (location TBD). Appetizers will be provided for members at no charge.
During the reception, a short Business Meeting will be conducted, during which the
winner of this year’s Resident Award will be presented. We encourage all members to
attend and network with your colleagues. To register for this event, please contact
Jacquilyn Davis at [email protected] or call 888-945-5430.
Additional details on the above events will be sent to all members via email in the
coming weeks. We hope to see you all in Philadelphia!