Psychiatric Emergency Care in Resource-Poor Areas

Abstract

Much of the literature on psychiatric emergencies is based on the experiences of established treatment facilities such as emergency rooms, crisis clinics, or psychiatric units. Thus, standard emergency protocols tend to overlook the problems of resource-poor areas such as limited manpower, inaccessibility of inpatient and outpatient facilities, and the economic, social, and political realities of various localities. Persons in rural regions generally live in numerous small villages (pop. 50–700) surrounded by vast expanses of agricultural lands, forests, or deserts. These communities receive social, commercial, and medical services from larger surrounding towns (pop. 2500–7500). Delivery of health care may be hampered by sheer distance, difficult to sparse road systems, and challenging climatic conditions. Since rural patients in crisis cannot easily be treated in standard settings, the concept of emergency care must be considerably broadened. It must comprise interventions that begin outside traditional treatment settings and may, for economic, geographic or social reasons, remain outside. Table 1 describes these settings.