This handbook addresses acute psychiatric presentations in the emergency department and in other acute settings. The author clearly understands the variable settings in which acute psychiatric care may be necessary and he gives useful guidance that could be helpful in any of these settings.

The book is divided into seven chapters. Early chapters deal with general psychiatric assessment in the acute setting, describe how to gather information, and give practical advice on how to take care of psychiatric emergencies. An assessment algorithm is presented that points out specific steps, from the triage assessment to the disposition, that should be followed in every emergency department. The chapters on the mental status examination and safety considerations are thorough, and updated references at the end of each chapter are a good guide for further reading.

The core of this handbook is the chapter on acute psychiatric presentations, which are alphabetized for quick reference. Each topic is presented in great detail, and the discussions are well organized and easy to read. However, page headers would be have been helpful to quickly search for a given topic.

The later chapters deal with special topics such as the use of physical restraint and consultation-liaison issues, special populations such as children and the elderly, and, particularly appreciated, a chapter on legal and forensic issues. Several appendixes at the end of the handbook include useful tools such as commonly used scales and, of course, a list of commonly used psychopharmacological agents.

This handbook should be required reading for psychiatry residents before they step into the emergency department, and it is a good guide for anyone dealing with acute psychiatric presentations. The pocket format of this handbook may be misleading, because pocket styles are most commonly used by trainees rather than experienced psychiatrists (so most of the reading will likely be done in the emergency department). However, a copy of it would be a useful addition to any emergency department or in any setting where psychiatry emergencies might be handled.