Mental Health of Older Adults in the Emergency Department

A mental health crisis in older adults typically refers to some form of acute behavioral crisis such as agitation in a patient with dementia,1 psychosis in the context of delirium,2 or a sudden behavioral change.3 A mental health emergency also refers to the older adult presenting with suicidal ideation. A mental health emergency may also be an acute presentation of an older person in distress as part of an exacerbation of an underlying diagnosed or undiagnosed serious mental illness or substance use disorder. It may also refer to serious psychiatric symptoms occurring as a consequence of a medical illness, or the treatment for that medical illness, such as the emergence of psychosis in Parkinson's disease or Lewy Body dementia. Accurate diagnosis, management, and disposition require careful investigation and reasoning through often complex multi-morbid illness and individual social context concerns.