Behavioral Health in the ED

In our series, we have covered many of the challenges that hospitals and physicians face from a behavioral health perspective, from burnout to boarding, and how telepsychiatry provides innovative solutionsHere, we continue our exploration into the psychiatric world and how telepsychiatry is helping to advance inpatient care in mental health hospitals. 

The Shortages Affecting Inpatient Care 

The United States has an alarming shortage of psychiatrists. With the wide-ranging mental health issues that patients face today, from opioid addiction to increasing rates of suicide and depression, this shortfall presents a quickly escalating crisis. A 2016 report by the Health Resources and Services Administration projected that by 2025 there will be a national shortage of 250,000 providers in behavioral health. 

The current shortage of providers has forced some patients to wait months before they can receive the care they so desperately need. More psychiatric offices are now moving away from accepting private insurance and if patients need immediate care, they invariably have to pay out of pocket rates. 

Not only are patients unable to find a psychiatrist, but they are also unable to find an inpatient care facility when they need one. 2012 report by the Treatment Advocacy Center, a nonprofit that works to remove treatment barriers for patients with mental health issues, found that the overall number of psychiatric beds actually decreased by 14% from 2005 to 2010.  

Combined, these issues are forcing more patients to seek care in emergency departments (ED) which are often illequipped and unprepared to treat them. Most mental health patients will wait for hours, if not days in the ED. This practice is called boarding and it happens when the appropriate care is not available. The fact is that the ED was not created to address long-term mental health issues. And mental health cannot be “fixed” in an instant. It requires personalized psychiatric interventions from trained professionals, often delivered over a period of time.

Improvements Through Telepsychiatry

Most, if not all these issues can be fixed through telepsychiatry. At MindCare, our team of employed board-certified psychiatrists are on call 24/7 to review records, evaluate patients, attend treatment plan meetings, admit, discharge, and quickly become a seamless member of a treatment team.  

Telehealth doctors need not travel long distances to see patients, cutting down on wait time, an important aspect of care in an area of health facing a growing shortage of providers. Research shows that telepsychiatry can reliably diagnose patients and that there is no difference in care outcomes compared to face-to-face visits. MindCare’s experience also shows that telepsychiatry can be less threatening and stressful for highly agitated patients. 

Another benefit of the telehealth method is that a doctor is always on call. Telepsychiatrists can work night shifts, conduct weekend rounding, and become a true member of the hospital medical staff.  

Patients and hospitals are not the only ones who benefit from this health model though. Providers find that they are able to achieve a better work-life balance and reduced stress while still being able to treat acutely ill patients in a hospital setting. With telehealth, these doctors no longer need to worry about morning commutes or evening traffic. They can treat patients anywhere in the US from the comfort of their home office.  

Virtual visits can also add a layer of safety for psychiatrists as well. Mental health patients can often be agitated or feel threatened. Online care provides a bit of distance between the provider and patient, while still providing the same quality of care. Correctional systems are now turning to telepsychiatry to provide care for incarcerated inmates. “Without telemedicine, we’d really be hurting,” said Dr. Joseph Penn, director of mental health services for UTMB Correctional Managed Care. This model also provides additional safety for the public as well since inmates do not need to be moved to different facilities to receive care.  

With the quickly growing care gap in mental health, telepsychiatry provides a path forward. Patients can receive quick, quality care and hospitals can rest assured that they are better able to meet their patients’ needs. At MindCare, we are building a culture of collaboration and excellence with a team dedicated to providing care for patients nationwide. If you would like to learn more about how telehealth is changing the face of mental healthcare or find out how you can offer our services, check out our full website or contact me directly.