Psychiatric Crises in the Emergency Room

Psychiatric Crises in the Emergency Room

Interview with Kesy Yoon, LMHC and James McMahill, LMFT

Kesy Yoon, LMHC: As a Licensed Mental Health Counselor (LMHC), I am dedicated to helping my clients understand who they are and how they fit into the world around them. Over the past six years, I have worked in a variety of mental health settings with individuals from all walks of life. Currently, I work with clients struggling with anxiety, perfectionism, trauma, and major life transitions. Over the course of my career, I have developed a specialty in working with the Asian American Pacific Islander (AAPI) 1st generation population. My work in this area is informed by my own personal experience with navigating the differences between an American upbringing and traditional Asian values. I enjoy working with AAPI clients to identify solutions to improve quality of life while honoring important cultural values and needs. Therapy is dynamic and my style is centered upon empowerment and hope. I show up as a human first, therapist second. As a counselor, I believe that every individual is a unique and complicated being; therefore, I do not have one uniform approach. I draw inspiration from several evidence-based modalities such as EMDR, Solution Focused Therapy and Cognitive Behavioral Therapy. I am also trained in the EMDR modality and I am currently in the process of EMDR Certification.

James McMahill, LMFT: I am an LMFT in CA and MN specializing in crisis care for those struggling with psychosis, severe depression, PTSD and suicidality. The majority of my clinical experience has been in crisis work and includes all ages, from children and adolescents in inpatient, TAY and adults in county outpatient clinics, and as a member of a Geri Psyche urgent response team. While in San Diego, I was the Program Director for Heartland Wellness Recovery Center, a county outpatient program serving SPMI clients in East County, San Diego. Currently, I am a team member for a CRT (Crisis Response Team) in Carver County, MN, and spend much of my clinical time in Emergency Rooms or responding to community or Law Enforcement mental health crises. I may also be commonly found co moderating Therapists in Private Practice (TIPP) on Facebook, with my wife Namrata.

In this episode we talk about:

• Continuing our special series on Fixing Mental Healthcare in America
• How emergency rooms become a part of the mental health system
• The role of emergency rooms as the first door for folks with a mental health crisis
• It can be a catchall and revolving door for some with longer term mental health concerns
• The challenges and overwhelm when someone comes into the ER
• The goals that emergency rooms can have when someone comes in with a psychiatric crisis
• The differences in ERs (whether they have psychiatric facilities or whether they transfer to other facilities)
• The challenges in placing clients in psychiatric inpatient care
• The revolving door – developing relationships and losing hope
• Potential legislation changes that could increase time for care
• Conflicting goals at different levels of the hospital and the hot potato syndrome
• Training of the emergency room staff, medical staff, law enforcement, fire services
• The criminogenic interpretation of behavior that can hinder law enforcement and seeing a patient as someone needing help
• The importance of patience in managing psychiatric crises
• Interacting with Law Enforcement in these situations