Mental Health Care Barriers in Emergency Rooms

Sign pointing to emergency room in hospitalAccording to research presented at an annual meeting of the American College of Emergency Physicians, the current shortage of medical professionals and care facilities in the United States is causing a traffic jam for those seeking emergency room services for mental health care. Many researchers say children are the most impacted by these barriers. One in five children are diagnosed with a mental health condition every year, and many of them end up in the emergency room after early intervention opportunities are passed over.

A combination of economic, political, and logistic factors has contributed to a growing crisis in health care as the demand for services continues to outpace the number of providers. While the effect is felt by many people seeking emergency services, those with mental health conditions tend to be in the emergency room for longer periods of time. They are also more likely to require admission into inpatient facilities. Both time and space have been restricted by inaccessible services, and people needing psychiatric care have had to deal with multiple barriers as a result.

Mental Health Service Statistics

The presentations at the annual meeting featured several scientific abstracts that illustrated the circumstances people with mental health issues face when seeking treatment. Presentations were based on data obtained from the National Hospital Ambulatory Medical Care Survey.

The data showed roughly 6% of all emergency room visitors had a mental health condition. Of this group, more than 20% required hospitalization and 11% had to be transferred to another facility. In contrast, only about 13% of patients with physical ailments needed to be admitted, and just 1.4% required transfer.

Emergency room visits for people with mental health issues usually require extra time to go along with the increased rates of admission and transfer. About 23% of people with mental health conditions stayed in the emergency room for more than 6 hours, in comparison to 10% of emergency room patients with physical issues. Additionally, stays of 24 hours or more were needed by about 1.3% of people with mental health concerns compared to 0.5% of those with physical ailments.

Mental Health Service Shortages

Researchers stated one of the main problems contributing to the emergency room bottleneck is a lack of inpatient beds for those with mental health concerns. People affected by this situation often repeatedly visit emergency rooms because they do not have access to the continuous treatments they need. Instead of going to the emergency room, they would likely have to rely on family practitioners who are rarely trained to provide the appropriate services.

The issue is only compounded when combined with a shortage of one-on-one mental health professionals in the average community, especially when it comes to pediatric psychological services. Even if they do get the services they need in the emergency room, follow-up care is often limited or completely nonexistent.

Researchers say there is no easy fix. Systematic changes at an institutional level may be required for people to get the kind of immediate treatment they need.

References:

  1. Ambulatory health care data. (2016, July 29). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/nchs/ahcd/
  2. Luthra, S. (2016, October 17). How gaps in mental health care play out in emergency rooms. NPR. Retrieved from http://www.npr.org/sections/health-shots/2016/10/17/498270772/how-gaps-in-mental-health-care-play-out-in-emergency-rooms
  3. Lynch, S., Bautista, M., Freer, C., Kalynych, C., & Hendry, P. (2015). Child mental health services in the emergency department: Disparities in access. Pediatric Emergency Care, 31(7), 473-478. doi:10.1097/PEC.0000000000000336

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  • Connie

    Connie

    October 26th, 2016 at 2:36 PM

    I fail to understand how our nation which has so much can still be so very lacking in providing basic health care to those who are the most in need

  • Louise

    Louise

    October 26th, 2016 at 4:05 PM

    I have also noticed that there is a shortage of speakers of a foreign language and how are these people going to receive adequate care when not one member of staff even speaks their language?

  • adam

    adam

    October 27th, 2016 at 11:05 AM

    One of the biggest problems is that those who may be trained in working with those in mental health issues are rarely going to be the employees who are on call in the ER. So maybe the answer comes with better education and a cross training of services in some way, so that there are always those available who at least have a basic understanding of what could be happening with this patient and how it should be managed until they can be given more intensive and specialized care.

  • Rosie

    Rosie

    October 27th, 2016 at 4:03 PM

    Feels like no matter what we try the healthcare system overall continues to get worse and worse.

  • Jason H

    Jason H

    October 28th, 2016 at 1:44 PM

    It is always a good idea to have someone with you, a friend or a family member, who can speak up and advocate for you.
    They might not have a full understanding of the health care that you need but they can do what needs to be done to ensure that you are being paid attention to and that you are at least being treated with kindness and respect.

  • bryan

    bryan

    October 29th, 2016 at 4:07 PM

    until we all start to feel that mental health is a priority then this is the way that things will stay

  • Selena

    Selena

    October 31st, 2016 at 10:26 AM

    Time and time again we have found that early intervention with children is the key.

    So why the hesitation to pour funding into that when we know beyond a shadow of a doubt that this is the answer?

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