How ERs fail mental health patients: 5 things to know

Although one in eight visits to the emergency department is related to a mental health or substance abuse issue, many EDs are unequipped to address these patients' needs, from regulation issues to a lack of community integration, according to a Health Affairs blog post.

Researchers at Cambridge, Mass.-based Institute for Healthcare Improvement and Oakland, Calif.-based Well Being Trust studied how mental healthcare can be integrated into EDs to understand what factors land these patients in emergency care situations.

Here are five things to know about the research.

1. Researchers analyzed relevant literature and conducted over 24 expert interviews with a wide range of stakeholders to understand existing approaches, gaps and opportunities for improvement for mental healthcare in the ED. 

2. The research indicated many existing approaches to ED care improvement only focus on revising the standard, reactive psychiatric consultation model. These models also rely on adding psychiatric resources, which are frequently limited.

3. The authors found other models aim to change one part of emergency psychiatric care, such as improving screening processes. "We believe that working on one part of the system alone is insufficient to bring about meaningful change," the authors wrote. "A new approach—one that takes a system view that intervenes at multiple points within health care and community-based settings — will have a greater impact than working on isolated parts of the system."

4. Factors that contribute to gaps in ED psychiatric care included a lack of standardized care processes within the ED, a lack of personnel with proper skills to care for mental health and substance abuse patients and a lack of input from patients' families in the ED care system.

5. To improve care for patients with mental health needs, the authors suggest EDs work to communicate and partner with other healthcare and community-based services, standardize processes from ED intake to for different mental health and substance abuse issues and ensure patients, family members and caregivers have enough information to for the patient to move toward self-managed care.


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