Thousands of patients a year who are experiencing psychiatric emergencies are admitted to emergency departments.
Many stay in the emergency department for hours; some even stay there for a few days. The practice, called psychiatric boarding, occurs when an individual with a mental health condition is kept in an emergency department because no appropriate mental health care is available. It’s rampant around the country.
Millions of Americans with mental health issues are not getting the care they need. It’s a crisis so profound that it is overwhelming emergency departments and the entire health care system. The causes? Too few outpatient resources and inpatient treatment options for mental health issues; separate systems for treating mental health and physical health; and a shortage of specialists able to respond to patients in the midst of mental health crises, to name just a few.
Too many people linger for extended periods in the emergency department, the most expensive and hardest way for them to get the help they need.
Jail and prison are now among the largest settings for mental health services, a final destination for individuals failed by the medical system. Yet neither correctional facilities nor emergency departments constitute the best therapeutic environment for people in the midst of mental health crises, and the care (or lack of it) they get there often leads to poor outcomes.
Given the consequences of inaction and insufficient resources, health care organizations need better tools, solutions, and integrated-care approaches so patients leave hospitals not just physically alive, but mentally thriving.
It doesn’t have to be like this. Individual health care providers can help change things by treating mental health conditions like any other disease process, instead of treating them like burdensome acute flare-ups that can be squashed and forgotten.
System-wide, when patients with psychiatric issues arrive in the emergency department, we need an easier way to transfer them to a higher level of care for psychiatric issues. Better coordination with mental health providers, even bringing such providers into the initial decision-making process, would speed treatment and free up emergency department resources.
We need to consider new ways to give health care workers real-time insights into the needs of psychiatric patients. We also need to consider better ways to “triage” psychiatric patients to more appropriate caregivers after they’re admitted to the emergency room. Finally, we need to be open to sharing data and best practices with each other so we can elevate the lives of our patients.
The better able we are to treat patients with mental and behavioral issues, communicate and collaborate effectively, and match patients with the appropriate resources outside of the emergency department, the better off our health system and our patients will be.
Adapted from STAT News.