Upsurge seen in ED patients with mental health issues

A recent upsurge in people with mental illness seeking treatment in EDs is taking a significant toll on patient care and hospital resources nationwide, according to an April 2004 survey of emergency physicians conducted by the American College of Emergency Physicians in Dallas; the American Psychiatric Association in Washington, DC; the National Alliance for the Mentally Ill in Arlington, VA; and the National Mental Health Association in Alexandria, VA.

Six in 10 emergency physicians surveyed report the increase in psychiatric patients is negatively affecting access to emergency medical care for all patients, causing longer wait times, fueling patient frustration, limiting the availability of hospital staff, and decreasing the number of available ED beds.

A total of 67% of emergency physicians attribute the recent escalation of psychiatric patients to state health care budget cutbacks and the decreasing number of psychiatric beds. One in 10 reports there is nowhere else in the community where people with mental illness can receive treatment. Mental health leaders claim that without ongoing, community-based services, people may see their illnesses worsen and be forced to seek care in EDs.

In addition, 70% of emergency physicians report an increase in people with mental illness boarding. More than 80% say that this practice negatively affects the care of ED patients. This agreement was almost universal (97%) among those who reported a rise in the boarding of psychiatric patients over the prior six to 12 months.

The report finds psychiatric patients board in EDs more than twice as long as other patients, and emergency physicians say their staff spend more than twice as long looking for beds for psychiatric patients than for nonpsychiatric patients.

The report is available free from ACEP. Contact Colleen Hughes at