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Psychiatry Clinic Acute Cases Department (5th Department)

The acute cases department consists of an admissions unit and men’s and women’s 15-bed acute care wards. The department has four psychiatrists, 20 nurses, 35 caregivers, a secretary, occupational therapist and security employees.
An on-duty nurse and on-duty doctor are stationed in the department’s admissions unit around the clock. This is the point of entry for emergency patients, as well as for other patients referred from the polyclinic or brought in by family members with a referral from a specialist or general practitioner.

Patients can also voluntarily seek admission at times when the polyclinic is closed.

Patients who arrive at the hospital as emergency cases are first examined by the on-duty doctor, who evaluates the patient’s psychological state and need for hospitalization. The patient’s state and treatment options are explained to him or her. If hospitalization is indicated, the patient reviews the terms of the treatment agreement and signs an treatment consent form, following which the patient is assigned to the department appropriate for his condition.

The Psychiatry Clinic’s receiving unit is often the point of entry for patients are who are not capable of understanding the problems and treatment needs they are experiencing and who pose a threat to themselves or others due to the unsuitable behaviour. Patients in such a condition include those with acute psychosis caused by schizophrenia, severe affective disorder, organic brain damage or intoxication as well as to patients who are not capable of making the necessary decisions due to low mental aptitude (mental developmental problems, dementia).

Patients are given information on treatment options, which, if refused, the on-duty physician is entitled in the cases specified in Section 11 of the Mental Health Act to hospitalize the patient involuntarily. The on-duty doctor also apprises the patient on his or her rights to contest the decision and informs a contact person provided by the patient that he or she has been hospitalized. Patients who require continuous monitoring due to psychotic agitation, suicide risk or physical injury are generally hospitalized in the acute cases wards located in the 5th Department.

Treatment procedures in the acute cases wards

Both the men’s and women’s acute cases wards have 15 beds.

While in the department, the patients undergo thorough screenings (labs, EKG, brain and other organ imaging or endoscopy), with consultations often made with an internal medical specialist, neurologist and other specialists for the purpose of refining the diagnosis. A psychiatrist evaluates the patient’s psychological state, makes a diagnosis and prescribes treatment.

Where possible, the choice of treatment methods takes into account the patient’s preferences.

The treatment is based on various modern psychiatric medications administered either orally or in injected form, depending on the patient’s condition. Electro-impulse therapy is a safe and effective treatment method for depression, and agitation or psychomotor retardation states. The therapeutic procedures are performed for all patients who need a given procedure in the 5th Department, which has specially customized rooms and trained personnel. Before electro-impulse therapy commences, the patient is briefed on the nature of the therapy, the expected results and the necessary dietary restrictions. Thereafter the patient provides consent for the treatment.

While in the acute cases wards, the patients are under constant supervision by medical personnel. The personnel dispenses medication, monitors condition, provides guidance and assistance to patients in daily hygiene, encourages activity through physical exercises and activities within their abilities. To ensure safety of patients and employees, a security guard is stationed constantly in the men’s and women’s wards.

To ensure the rights of patients who have been involuntarily hospitalized, the Harju County Court conducts field hearings three times a week in the 5th Department. In the course of these hearings, a judge hears patient testimony and evaluates whether circumstances dictate the utilization of involuntary commitment. The state appoints the patient a defender for the protection of the patient’s constitutional rights. Permission or refusal for involuntary psychiatric commitment is issued by court decision.

When acute psychotic agitation and suicide risk have passed (usually patients are in the acute cases wing for a short time) most patients continue therapy in other departments of the Psychiatry Clinic or as outpatients. When compliance increases, the patient signs a therapy consent form and the involuntary treatment is ended.

5th Department of the Psychiatry Clinic is the core of inpatient care at the clinic

dr Katrin Eino
head of the 5th Department of the North Estonia Medical Centre’s Psychiatry Clinic

Psychiatry Clinic

Psychiatry Clinic Acute Cases Department (5th Department)

+ 372 617 2650

Dr Katrin Eino

Head of Department

+ 372 617 2664