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RESEARCH WEEKLY: Beyond 'Delayed and Deteriorating'
Tomorrow, the Office of Research and Public Affairs of the Treatment Advocacy Center will release an evidence brief titled Delayed and Deteriorating: Serious Mental Illness and Psychiatric Boarding in Emergency Departments. The paper represents the findings and synthesis of a comprehensive review of academic and grey literature on the boarding of psychiatric patients in emergency
departments, and the role and disproportionate impacts on people living with serious mental illness.
Psychiatric boarding is a widespread phenomenon in the United States. Boarding occurs when an individual in need of psychiatric treatment goes to a hospital emergency department and is subsequently forced to wait for extended periods of time before any meaningful treatment is received.
Without other options in the community, individuals in psychiatric crisis have little choice other than a local emergency department. Emergency departments are thus inundated with individuals seeking help for conditions that likely could be better served elsewhere in a functioning system of care. According to a 2016 survey from the American College of Emergency Physicians, over 90% of emergency physicians say psychiatric patients board in their emergency departments.
Serious mental illness is a significant contributor to emergency department boarding, and people with serious mental illness are disproportionately affected by boarding compared to other behavioral health disorders or the general population. Therefore, "any solutions to combat psychiatric boarding must address treatment gaps for individuals suffering from these conditions," according to the brief authors.
Importantly, future work is needed in determining the extent of psychiatric boarding at the state and national level. Such efforts represent a unique opportunity to assist in answering perhaps one of the most salient questions in mental health care policy: how many psychiatric beds does a community need? Quantitative indicators that can be measured, such as the extent of psychiatric boarding in emergency departments, can help communities better understand and address the critical treatment needs of their populations.
Make sure you check your inbox tomorrow for a full-copy of the brief. It will also be available on the Treatment Advocacy Center website.
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