Let’s Take Our National Mental-Health Crisis Out of the Emergency Room

Tonight, countless acute mental-health patients desperate for help will arrive at their local emergency room only to be detained under guard for days as they wait for suitable psychiatric care. It’s a crisis of health-care delivery that, at a minimum, would benefit from the leadership of a national task force to develop solutions for a problem caused by poor funding for community care.

The issue of mental-health patients being “boarded” in emergencies rooms, whether they arrive there themselves or are brought by police unable to handle a mental-health crisis, is endemic. It’s an economic imperative to solve this problem because it wastes resources and, since behavioral treatment has better outcomes the sooner it begins, it’s also a moral one.

This comes at a time when we lament the prevalence of mass shootings and a rising number of suicides throughout the United States; removing barriers to decent treatment of anyone in a mental-health crisis should be a top priority.Today, vulnerable patients and their families suffer needless stress awaiting proper medical treatment in emergency room settings, where staffs aren’t trained in providing help for mental-health patients. Typically, staffs put these patients under guard, often in a small exam space where they are confined until a bed becomes available at a mental-health facility. They aren’t provided any therapeutic care — and treatment doesn’t begin until they’re placed elsewhere.

An American College of Emergency Physicians survey of 328 emergency rooms found that roughly 80% boarded psychiatric patients, holding them in a noisy, chaotic emergency room waiting for a transfer to another inpatient facility. In Georgia, for example, waits average 34 hours and often last several days before a psychiatric inpatient bed is available. In Maryland, many emergency rooms board up to a dozen psychiatric patients for days at a time.

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