Bottlenecks in mental health services – Part 2: Overcrowding ERs affecting psychiatric patients’ treatment

Bottlenecks in mental health services – Part 2: Overcrowding ERs affecting psychiatric patients’ treatment

Lack of inpatient psychiatric beds in the United States is posing hurdles in the treatment of mental disorders. Studies over the past decade have shown that emergency room (ER) overcrowding has resulted in higher mortality rate of patients in the ER, in higher costs of medical treatment and in higher stress levels for medical professionals.

According to the American College of Emergency Physicians (ACEP), there has been a steady increase in the wait times and longer stays in emergency departments for people suffering from psychiatric disorders. As per an online survey released in October 2016 by ACEP, of more than 1,700 ER doctors, more than seven out of 10 ER physicians reported seeing patients during their last shift who were waiting for inpatient beds. A third of these doctors stated that patients suffering from mental disorders had to wait at least two days for a bed.

As per Rebecca Parker, M.D., F.A.C.E.P., president of the ACEP, psychiatric patients wait in the emergency departments for hours and even days for a bed that negatively affects their treatment. The lodging of mental patients in ERs also affects the care received by other emergency patients.

As part of the series, “Bottlenecks in mental health services,” let’s take a look at how scarcity of psychiatric beds in ERs impacts the treatment of mentally ill patients.

Scarcity of psychiatric beds and its effect on mental health care

For decades, the number of beds in government-funded hospitals for people suffering from various mental illness has been going down. As per the Treatment Advocacy Center, there were more than 330,000 beds in 1970. However, by 2010 it came down to less than 50,000.

As per a research presented at an ACEP meeting in October 2016, lack of psychiatric beds and boarding of mental patients in ERs make them overcrowded with patients in need of physical care and those needing help for mental illness. The situation has led to patients competing for resources.

According to a related study published in the journal Health affairs, the length of stay for psychiatric visits was much longer with 80 percent of ERs boarding mental health patients. As per co-author of the study Dr. Renee Hsia, director of health policy studies in the Department of Emergency Medicine at the University of California at San Francisco, ERs have become a dumping ground for psychiatric patients and due to excessive boarding, the ERs are at a breaking point.

Long waits for beds affecting young patients

The boarding of psychiatric patients in the ER is not a new phenomenon, but long waits could be traumatizing for young psychiatric patients. As per Dr. Jane Brice, chairperson of the Emergency Medicine Department at the University of North Carolina, children are not meant to be confined in spaces where they do not have sufficient resources or education to help them get better.

In case of shortage of psychiatric beds, it is usually the youngest patients who suffer the most. As per the American Academy of Child and Adolescent Psychiatrists, for every 100,000 children, there should be 47 child psychiatrists. However, most states average fewer than 17 child psychiatrists and there are several counties in the U.S. that have no child psychiatrist at all. Due to lack of mental health services, young psychiatric patients often do not get access to regular psychiatric follow-ups after treatment.

Help at hand

As per the American Hospital Association, the number of public and private psychiatric beds (children and adults) fell in 33 states across the U.S. during 2010-2014. The shift has come as a result of deinstitutionalization efforts and shifting of mental health resources out of hospitals and into local communities. As per Thomas Chun, an associate professor of emergency medicine and pediatrics at the Brown University, longer stay in cramped and overused emergency departments can often have harmful effects on the health of psychiatric patients.

If you or your loved one is suffering from some kind of mental illness and is in need of treatment, contact the California Mental Health Helpline to know about various psychological rehabilitation centers in California. Call us at our 24/7 helpline number 855-559-3923 or chat online with our experts to find some of the best mental health centers in California.

Read the other articles of the series, “Bottlenecks in mental health services”:

Part 1: California’s shortage of psychiatric bed impacts mental treatment

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