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RESEARCH WEEKLY: Community Mental Health Centers and Psychiatric Emergency Department
Visits

Expansion of primary care services provided by community health centers may result
in a decrease in psychiatric emergency department visits, according to research
released in June.

Community health centers (CHCs) represent a federal government effort to increase
access to health care for low-income, underserved communities. CHCs provide both
primary care and preventive services [[link removed]]
such as health screenings and management of chronic conditions, and currently serve
more than 28 million Americans across the country. CHCs also deliver a number of
additional services to facilitate care for the populations they serve, including
transportation to and from clinics for appointments, translation for those who speak
other languages, and health education on chronic disease management and wellness.

One key metric for CHCs in providing cost-efficient care is the reduction of avoidable
emergency department (ED) visits. For individuals without regular access to primary
care, the ED can serve as a costly last-resort when conditions have been left untreated.
This reality is especially problematic for individuals with mental illness, whose
undiagnosed or inadequately managed symptoms can culminate in a psychiatric crisis,
from which recovery may be more difficult. EDs are also particularly ill-suited
for treating chronic conditions such as mental illness that often require the expertise
of a specialist with an eye toward long-term care.

Utilizing data from a nationwide reporting system for CHCs and the State Emergency
Department Database, a team of researchers explored the relationship between CHC
primary care visits and psychiatric ED visits to determine whether CHCs were reducing
ED visits for individuals with mental illness. The researchers analyzed data for
143 counties across nine states between 2006 and 2011.

Results of the analysis showed that for a given county, an increase in CHC visits
was associated with a decrease in psychiatric ED visits, measured by population
and over time. In a county with a population of 100,000 people, for example, the
data suggest a decrease of six psychiatric ED visits for every increase of 100
CHC visits.

The authors note that their research cannot speak to the quality or level of mental
health care provided by CHCs as a component of primary care, or a direct association
between an individual patient's care at a CHC and his or her future ED use. However,
the findings indicate a potential role for the expansion of CHCs in diverting individuals
from utilizing the ED for psychiatric care, and could have implications for public
health policy.
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References:

*
Bruckner, T. A., et al. (2019, June). Psychiatric Emergency Department Visits [[link removed]]
after [[link removed]]
Regional Expansion of Community Health Centers. [[link removed]]
Psychiatric Services.
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Jessica Walthall
Research and Advocacy Associate
Treatment Advocacy Center
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Research Weekly is a summary published as a public service of the Treatment Advocacy
Center and does not necessarily reflect the findings or positions of the organization
or its staff. Full access to research summarized may require a fee or paid subscription
to the publications.
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The Treatment Advocacy Center does not solicit or accept funds from pharmaceutical
companies.
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