Identified or not, a large percentage of ED visits in the United States are related to substance abuse and other behavioral health issues.1 Some patients with these problems are seen so frequently in the emergency department that they become well known to many of the staff. Even in emergency departments with mental health professionals on staff or who are available for consultations, the bulk of patient encounters, particularly at night and on weekends, is with nurses. Motivational interviewing (MI) is an evidence-based approach that has been shown to improve the effectiveness and reduce the frustration of ED staff who work with persons who have addictions and exhibit other self-destructive behaviors.
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