Viewpoint: What hospitals can do to help EDs overwhelmed by psychiatric patients

As hundreds of patients facing psychiatric emergencies are admitted to emergency departments each year, hospitals can help prevent EDs from being overwhelmed by taking several key actions, starting with better collaboration, an emergency medicine director writes in a STAT op-ed.

"Millions of Americans with mental health issues are not getting the care they need. It's a crisis so profound that it is overwhelming emergency departments and the entire healthcare system," writes op-ed author Anne Zink, MD, medical director for emergency medicine at Palmer, Alaska-based Mat-Su Regional Medical Center.

The causes behind this trend include too few outpatient resources and inpatient treatment options for mental health issues, separate systems for treating mental health and physical health and a mental health specialist shortage, Dr. Zink says.

Five insights from the op-ed:

1. "Given the consequences of inaction and insufficient resources, healthcare organizations need better tools, solutions and integrated care approaches so patients leave hospitals not just physically alive, but mentally thriving," Dr. Zink writes.

Healthcare providers can help patients thrive by treating mental health conditions like any other disease process, as opposed to treating them like acute flareups that easily can be forgotten or overlooked, Dr. Zink says.

2. Hospitals need an easier way to transfer patients to a higher level of care for psychiatric issues when they arrive at the ED, Dr. Zink says. "Better coordination with mental health providers, even bringing such providers into the initial decision-making process, would speed treatment and free up emergency department resources," she writes.

3. Novel technology also can improve collaboration between emergency and behavioral health providers to ensure all clinicians are on the same page. Mat-Su Regional Medical Center, along with most Alaska hospitals, are part of the collective medical network, which connects the facilities to other providers in the state and across the U.S., Dr. Zink says.

Since patient information is aggregated, when a patient arrives at the ED, the network gives real-time alerts to physicians on a patient's data, including their history of psychiatric care and ED use patterns.

"For my hospital, this tool has been a game changer," Dr. Zink writes.

4. Additionally, expanding access to behavioral telehealth can help more patients get the mental healthcare they need before they resort to the ED, Dr. Zink says.

"Through a virtual care platform, patients with transportation issues and other challenges can receive counseling at home more easily than if they were to wait hours for a psychiatric worker to conduct an initial consultation in person," she writes.

5. Hospitals must consider new ways to give healthcare workers real-time insights into psychiatric patients' needs, better ways to triage psychiatric patients to more appropriate caregivers and be open to sharing data and best practices with other hospitals to improve patients' quality of life, Dr. Zink says.

"The better able we are to treat patients with mental and behavioral issues, communicate and collaborate effectively, and match patients with the appropriate resources outside of the emergency department, the better off our health system and our patients will be," Dr. Zink writes.

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