Emergency telepsychiatry can improve patient care and satisfaction, reduce boarding of emergency department (ED) psychiatric patients, improve the accuracy of psychiatric diagnoses made in the ED, and decrease the baseline admission rate to psychiatric hospitals. It is important that a telepsychiatrist perform a remote site assessment before initiating services. An onsite assessment should be used to help the telepsychiatrist become aware of local collaborators and service agencies. The guidelines indicate that there should be attention to certain clinical issues. Identification and selection of qualified consulting telepsychiatrists and associated support systems are the keys to a successful collaboration in the ED. Early in the process for implementing telepsychiatry consultation to emergency departments, information technology (IT) staff should be involved. The final phase of implementation involves staff training. ED staff should know what the criteria are for getting a telepsychiatry consultation.