November 14, 2019
Lack of Adequate Treatment Options for People with Serious Mental Illness Causing Steadily Increasing Crisis at Emergency Departments, a new Treatment Advocacy Center Brief Finds
The Treatment Adocacy Center calls for reforms to address care gaps for individuals with severe mental illness who are disproportionately impacted by psychiatric boarding
ARLINGTON, VIRGINIA - Appropriate psychiatric care is not available to people with severe mental illness, and as a result, the number and proportion of visits to emergency departments for mental health crises have steadily increased, according to a new evidence brief released today by the Treatment Advocacy Center.
“Delayed and Deteriorating: Serious Mental Illness and Psychiatric Boarding in Emergency Departments” reports that individuals with serious mental illness are disproportionately impacted by long wait times in emergency departments, a phenomenon known as “boarding.” These individuals experience longer waits than non-psychiatric patients, with more serious consequences, including making recovery less achievable and more costly to the health care system.
The Treatment Advocacy Center called on the federal government to institute reforms to address systems gaps for those with the most severe psychiatric disorders, including increasing the supply of psychiatric beds.
“Our system simply doesn’t take serious mental illness seriously,” said John Snook, executive director of the Treatment Advocacy Center.
“Emergency departments are being flooded with individuals seeking help for a serious mental illness that could be better served elsewhere in a functioning system of care,” he said. “This failure is devastating for individuals with serious mental illness, other patients and the health care system as a whole.”
Emergency department visits related to mental health or substance use have grown by 41% - from 7.1 million to more than 10 million – in just six years. In addition, despite the expectation of parity between mental health and physical health care, psychiatric patients are more than twice as likely to experience emergency department stays of more than 24-hours as non-psychiatric patients are, with individuals presenting with a serious mental illness the most likely to experience long waits.
This disparity is especially true for psychiatric patients who require inpatient care for their recovery. Psychiatric patients who are admitted to the hospital for inpatient care or transferred to another inpatient facility are most likely to experience boarding and wait the longest for placement of any patient.
Psychiatric boarding also presents huge costs for the health care system. An emergency department visit in which an individual is boarded costs hundreds more than a visit involving timely treatment. Boarding also prevents emergency departments from admitting and being reimbursed for additional patients, as much as $2,264 per patient in one study. State and local governments also experience costs in the form of lawsuits, as litigation to combat psychiatric boarding has sprung up across the nation.
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The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illness. The organization promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.