Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies

The goal of this observational study is to examine the effect of using a video link for evaluation of patients in the psychiatric emergency room. Under current Israeli law, the attending physician must come in to physically examine the patient before they can be admitted involuntarily. Patients often de-compensate and even may become violent while waiting for the attending to arrive. Previous studies have shown that evaluation of such patients via video-link has an extremely high concordance with in person evaluation. This study will compare patients who are evaluated via video-link with historical controls evaluated under usual conditions. This is an observational study, which is taking advantage of a change in practice to collect data on two different ways of delivering care, via chart reviews. If successful, this study will show that the video-link is feasible and acceptable to patients and staff. The following hypotheses will be tested:

1. The intervention will result in shorter ED time compared to historical controls. 2. The intervention will result in fewer violent incidents compared to historical controls. 3. The intervention will result in shorter overall hospital length of stay compared to historical controls.