Wanted: Psychiatric Specialists in the Emergency Room

by Bill Brenner on April 20, 2011

A friend directed me toward a disturbing story on NPR’s website about the mentally ill languishing in ERs.

Mood music:

[youtube http://www.youtube.com/watch?v=NkJOZOOXJWk&fs=1&hl=en_US&rel=0]

Here’s the first few paragraphs of the report by Jenny Gold:

As he lay on a gurney in the emergency department of Memorial Hospital of Rhode Island, Erik grew increasingly upset. He had called the police to report a theft from his apartment, but wound up being taken to the hospital.

The ER staff quickly determined that Erik, 40, who has been diagnosed with schizoaffective disorder and PTSD, needed urgent psychiatric care, but there wasn’t much they could do.

Like many hospitals, Memorial doesn’t have a psychiatric unit, and all of the psychiatric units in the nearby facilities were full. Erik, a bright, articulate and devoutly religious man, had to wait nearly two days on a gurney in the ER before he could be transferred.

Mentally ill patients often languish in hospital emergency rooms for several days, sometimes longer, before they can be moved to a psychiatric unit or hospital. At most, they get drugs but little counseling, and the environment is often harsh.

A few thoughts on this:

–This is disturbing as hell when you consider the fact that when you listen to the phone recording from just about every therapist’s office, you are directed to the nearest emergency room in a crisis situation. Someone in a desperate state goes to the ER as directed only to find no help.

–The typical ER is an infuriating place to be because you almost always wait for hours unless you’ve been brought in by ambulance or you have blood pouring out all over the floor. I don’t necessarily blame ER staff for this. They never have enough resources. Some will debate me on that, but I’ve been in enough ERs to make the observation.

In the final analysis, I think the main responsibility for fixing this problem starts with the upper-level hospital administrators and boards of directors. They need to make it a priority to have emergency assistance for people with mental health emergencies.

If there’s a good reason they can’t do this, and I doubt there is, then mine and other therapists need to stop telling people to go to the emergency room.

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