Dionne Hart, MD

The setting of a fast-paced emergency department (ED) or psychiatric emergency service makes it especially difficult to sensitively elicit and address an individual patient's needs and concerns. When considering the myriad differences in culture that come into play between a patient and a psychiatrist or other mental health care clinician, optimal diagnosis and treatment can be even more challenging, as the cases described here illustrate. The important influence of culture cannot be stressed enough. Taking the time to understand "where the patient is coming from" can prevent an already stressful, highly emotionally charged situation from becoming even more convoluted.