Nearly two-thirds (61 percent) of emergency room (ER) physicians who
responded to a recent survey reported an increase in the number of patients
who had psychiatric emergencies in the previous six to 12 months.
The American College of Emergency Physicians (ACEP) undertook the survey in
March 2004 in partnership with APA, the National Mental Health Association,
and the National Alliance for the Mentally Ill.
The survey was conducted online, after 340 respondents replied to an
invitation in the ACEP newsletter.
Two-thirds of the respondents (67 percent) have noticed more psychiatric
patients "boarding" in the emergency room.
According to 81 percent of the respondents, the increase in boarders has a
negative effect on the care of other patients. Among the problems are
decreased availability of ER staff for other patients, longer waits for
patients in the waiting room, and patient frustration.
Eleven percent of the respondents said they knew of nowhere but the
emergency room for patients with psychiatric emergencies to receive care.
Forty-eight percent of respondents said that the number of psychiatric beds
in the region had decreased in the preceding six to 12 months. Less than a
quarter (24 percent) said the number had not decreased, and the remainder did
More than 90 percent of the respondents who have seen an increase in the
number of patients with psychiatric emergencies attribute the change to state
budget cuts to Medicaid, decreasing number of psychiatric beds, or a
combination of the two.
"The findings underscore the serious consequences that state budget
cuts to programs like Medicaid are having not only for people with mental
illness, but for anyone who might find himself or herself in an emergency
room," said APA Medical Director James H. Scully Jr., M.D.
A press release on the survey, titled "Emergency Departments
See Dramatic Increase in People with Mental Illness Seeking Care," is
posted online at<www.psych.org/news_room/press_releases/emergencystudy06032004.pdf>.▪