considerations. dependent upon legal requirements in the region, mental health professionals may be required to report criminal activity to a police force. mental health professionals will usually gather identifying data during the initial assessment and refer the patient, if necessary, to receive medical treatment. medical treatment may include a physical examination, collection of medicolegal evidence, and determination of the risk of pregnancy, if applicable. treatment treatments in psychiatric emergency service settings are typically transitory in nature and only exist to provide dispositional solutions and/or to stabilize life-threatening conditions. once stabilized, patients with chronic conditions may be transferred to a setting which can provide long term psychiatric rehabilitation. prescribed treatments within the emergency service setting vary dependent upon the patient's condition. different forms of psychiatric medication, psychotherapy, or electroconvulsive therapy may be used in the emergency setting. the introduction and efficacy of psychiatric medication as a treatment option in psychiatry has reduced the utilization of physical restraints in emergency settings, by reducing dangerous symptoms resulting from acute exacerbation of mental illness or substance intoxication. medications with time as a critical aspect of emergency psychiatry, the rapidity of effect is an important consideration. pharmacokinetics is the movement of drugs through the body with time and is at least partially reliant upon the route of administration, absorption, distribution and metabolism of the medication. a common route of administration is oral administration, however if this method is to work the drug must be able to get to the stomach and stay there. in cases of vomiting and nausea this method of administration is not an option. suppositories can, in some situations, be administered instead. medication can also be administered through intramuscular injection, or through intravenous injection. the amount of time required for absorption varies dependent upon many factors including drug solubility, gastrointestinal motility and ph. if a medication is administered orally the amount of food in the stomach may also affect the rate of absorption. once absorbed medications must be distributed throughout the body, or usually with the case of psychiatric medication, past the blood–brain barrier to the brain. with all of these factors affecting the rapidity of effect, the time until the effects are evident varies. generally, though, the timing with medications is relatively fast and can occur within several minutes. as an example, physicians usually expect to see a remission of symptoms thirty minutes after haloperidol, an antipsychotic, is administered intramuscularly. antipsychotics, especially haloperidol, as well as assorted benzodiazepines are the most frequently used drugs in emergency psychiatry, especially agitation. psychotherapy other treatment methods may be used in psychiatric emergency service settings. brief psychotherapy can be used to treat acute conditions or immediate problems as long as the patient understands his or her issues are psychological, the patient trusts the physician, the physician can encourage hope for change, the patient has motivation to change, the physician is aware of the psychopathological history of the patient, and the patient understands that their confidentiality will be respected. the process of brief therapy under emergency psychiatric conditions includes the establishment of a primary complaint from the patient, realizing psychosocial factors, formulating an accurate representation of the problem, coming up with ways to solve the problem, and setting specific goals. the information gathering aspect of brief psychotherapy is therapeutic because it helps the patient place his or her problem in the proper perspective. if the physician determines that deeper psychotherapy sessions are required, he or she can transition the patient out of the emergency setting and into an appropriate clinic or center. ect electroconvulsive therapy is a controversial form of treatment which cannot be involuntarily applied in psychiatric emergency service settings. instances wherein a patient is depressed to such a severe degree that the patient cannot be stopped from hurting himself or herself or when a patient refuses to swallow, eat or drink medication, electroconvulsive therapy could be suggested as a therapeutic alternative. while preliminary research suggests that electroconvulsive therapy may be an effective treatment for depression, it usually requires a course of six to twelve sessions of convulsions lasting at least 20 seconds for those antidepressant effects to occur. observation and collateral information there are other essential aspects of emergency psychiatry: observation and collateral information. the observation of the patient's behavior is an important aspect of emergency psychiatry as it allows the clinicians working with the patient to estimate prognosis and improvements/declines in condition. many jurisdictions base involuntary commitment on dangerousness or the inability to care for one's basic needs. observation for a period of time may help determine this. for example, if a patient who is committed for violent behavior in the community, continues to behave in an erratic manner without clear purpose, this will help the staff decide that hospital admission may be needed. collateral information or parallel information is information obtained from family, friends or treatment providers of the patient. some jurisdictions require consent from the patient to obtain this information while others do not. for example, with a patient who is thought to be paranoid about people following him or spying on him, this information can be helpful discern if these thoughts are more or less likely to be based in reality. past episodes of suicide attempts or violent behavior can be confirmed or disproven. disposition patient receive emergency services often on a time limited basis such as 24 or 72 hours. after this time, and sometimes earlier, the staff must decide the next place for the patient to receive services. this is referred to as disposition. this is one of the essential features of emergency psychiatry. hospital admission the emergency care process. the staff will need to determine if the patient needs to be admitted to a psychiatric inpatient facility or if they can be safely discharged to the community after a period of observation and/or brief treatment. initial emergency psychiatric evaluations usually involve patients who are acutely agitated, paranoid, or who are suicidal. initial evaluations to determine admission and interventions are designed to be as therapeutic as possible. involuntary commitment involuntary commitment, or sectioning, refers to situations where police officers, health officers, or health professionals classify an individual as dangerous to themselves, others, gravely disabled, or mentally ill according to the applicable government law for the region. after an individual is transported to a psychiatric emergency service setting, a preliminary professional assessment is completed which may or may not result in involuntary treatment. some patients may be discharged shortly after being brought to psychiatric emergency services while others will require longer observation and the need for continued involuntary commitment will exist. while some patients may initially come voluntarily, it may be realized that they pose a risk to themselves or others and involuntary commitment may be initiated at that point. referrals and voluntary hospitalization in some locations, such as the united states, voluntary hospitalizations are outnumbered by involuntary commitments partly due to the fact that insurance tends not to pay for hospitalization unless an imminent danger exists to the individual or community. in addition, psychiatric emergency service settings admit approximately one third of patients from assertive community treatment centers. therefore, patients who are not admitted will be referred to services in the community.