The burden of mental illness is profound and growing.

Coupled with large gaps in

extant psychiatric services, this mental health burden has often forced emergency
departments (EDs) to become the de facto primary and acute care provider of mental
health care. An expanded emergency medical and mental health research agenda is
required to meet the need for improved education, screening, surveillance, and
interventions for mental health problems. As an increasing fraction of undiagnosed and
untreated psychiatric patients passes through the revolving doors of the emergency
department, the opportunities for improving the art and science of acute mental health
care have never been greater.

The Mental Health Emergency Care-Rural Access Project (MHEC) service was
developed in response to community concerns about poor access to emergency mental
health care. While rural residents accept that they may need to travel for health care
that cannot be provided locally, the opportunity to develop novel solutions to problems
that are not amenable to conventional approaches can result in improved access to
services delivered locally through use of new technologies. The new service was
managed by a team of mental health nurses and psychiatrists working from the primary
MHIPU and incorporated staff and resources from an existing 24-hour telephone triage,
information, and support service.

Emergency telepsychiatry delivered by videoconferencing has the potential to

improve patient care in many settings. Although experience is limited, it has been found
to be safe and effective, as well as satisfactory to both emergency department staff and
the psychiatric patients treated. Emergency telepsychiatry has the potential to reduce
emergency department overcrowding, provide much needed care in rural areas and
improve access to psychiatric care in the event of a natural or man-made disaster.