Behavioral Health in the ED

In many US communities, emergency departments are one of the last remaining safety nets for mental health patients. One in eight visits to the emergency room (ER) today is related to mental health or substance abuse issues. Starting in the 1980s continuing through the 90s, mental health was de-institutionalized around the country in an effort to modernize mental health care. Many of these community facilities were not replaced with outpatient care centers though, and ERs are still poorly equipped to serve patients with mental health issues. With problems piling up, it is time for a new system of care.

A Growing Problem

The lack of outpatient care and underfunded community public health leaves many mental health patients with no other choice but to go to the ER when they are experiencing psychotic episodes, medication side effects, or any number of other issues related to mental health and even substance abuse. Today, 61% of ERs do not have psychiatric staff, and mental health patients often find themselves being boarded for hours, days, or even weeks before they can get a hospital bed.

This long wait time has been shown to lead to poorer outcomes for mental health patients. It can get so extreme that patients feel traumatized, or even stripped of their dignity. ER culture, lack of training, and stigmas against mental health also add to the growing problem and increasing demands on ERs will only exacerbate the current issues.

Improving the System

With mental health visits to the ER rising and ER workers unprepared, an improved system of care is needed to better serve mental health patients in ERs. It has already been shown that enhanced care management through better coordination and follow-up leads to improved outcomes and reduces the amount of repeat ER visits for mental health patients. ERs must work towards incorporating not only physical health but also mental health issues into their everyday care plans and treatment protocols.

In past articles, we have covered how telepsychiatry is helping to set a new standard of care by increasing access to trained specialists, helping to facilitate follow-up care, and offering better care coordination. Telepsychiatry is only one part of the puzzle though. It must be backed up by a system and team who are ready and able to not just fill in but to consult, collaborate, and work together.

Going Beyond Telehealth

At MindCare, our teams are prepared to do just that. Our goal is not just to provide excellent telehealth service, but to build an improved system through the use of telehealth. MindCare not only allows patients quick and reliable access to trained specialists, but we also offer education services around mental health to other healthcare professionals such as ER physicians, nurses, and hospital administrators. By increasing education, we can work together with ER teams to ensure a better care environment for patients with behavioral health needs.

Our team also collaborates with available community services to decrease patient boarding and help streamline placement. MindCare specialists are available to help treat patients while they wait for a bed to open. In some cases, this care results in patients no longer even needing to be admitted.

Our psychiatrists can obtain labs, review records and tests, consult with referring physicians, and help with outpatient planning, all the while working in coordination with the on-site care team.

MindCare strives to go above and beyond just providing exceptional telehealth services. We are creating a new, and better system of care to ensure every patient receives the compassionate care and best quality medical treatment they deserve.