ERs struggle to divert psychiatric patients

Lack of support for mental health services continues to adversely affect hospitals, with Minnesota emergency departments increasingly forced to act as holding cells for patients who pose a threat to both healthcare workers and other patients, according to the Minneapolis Star Tribune.

Officials at two of Minnesota's biggest health systems, Essentia Health and Allina Health, say they have been forced to turn ambulances away due to bed overcrowding. Providers have diverted emergency patients to as far away as Fargo, North Dakota, according to the article. Meanwhile, Detroit Lakes' St. Mary's Hospital is constructing its second "safe room," which has no furniture except a stretcher bolted to the floor, to house ER patients who may be a danger to themselves. Across the state, caring for mentally ill patients has become the top issue for private hospitals, Matt Anderson, a senior vice president at the Minnesota Hospital Association, told the publication.

The problem, however, is far from exclusive to Minnesota. In California, psychiatric beds are failing to keep up with demand, according to National Public Radio. The California Psychiatric Association has thrown its support behind a state bill that would establish an online directory aiding medical providers searching for psychiatric beds, but the California Hospital Association, which opposes the bill, argues that meeting individual psychiatric patients' needs requires far more than simply finding an available bed.

To avoid subjecting patients to lengthy stays in unprepared ERs, Chico, California's Enloe Medical Center created a voluntary acute care mental health program in 1998, according to Healthcare Finance News. Patients are referred from the local community or Enloe's emergency department. The 30-bed unit discharges up to 800 patients a year. The environment, significantly less chaotic than the ED, keeps patients with behavioral health issues from getting lost in the shuffle of emergency care.

Similarly, Salt Lake City-based Intermountain Healthcare has embedded mental health workers in its primary care clinics, and this emphasis on behavioral health has cut ER visits, admissions and preventable admissions, according to MedCityNews. About 150,000 Intermountain patients a year have medical problems that require mental healthcare.

Another possible answer to the problem? Closer collaboration between emergency providers and psychiatrists, argues Psychiatry Advisor. "The trust and openness will pay dividends down the road," the column states. "A psychiatrist who believes that he or she is getting the full story from an [emergency] physician will likely develop confidence in that individual and be more accepting of patients in the future."

To learn more:
- here's the Star Tribune article
- read the NPR story
- read the Healthcare Finance News article
- here's the MedCityNews article
- check out the Psychiatry Advisor column

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.