Emergency Rooms Show Gaps in Mental Health Care System

November 17, 2016 (All day)

A new research analysis offers insights into how frequently patients with mental health issues land in the emergency room -- often because opportunities to intervene earlier are missed. Pediatricians and child psychiatrists say children are among the hardest hit.

Compared with physically ill patients, people with mental health conditions rely more on the emergency department for treatment and are more often admitted to the hospital from the ER, the scientists found. Also, they tended to be stuck in the ER longer than people who show up in the ER with physical symptoms. Patients who come to the ER because of physical ailments can usually be sent home, Lippert says, "because we know they'll be evaluated by [their] doctor in one or two days." But psychiatric patients don't always have that option because of gaps in the mental health care system.

Meanwhile, the young patients are even less likely to get reliable care after they are discharged from the ER. Whether they need regular follow-up with a psychiatrist, or a transfer to specialized facility, the resources often aren't in place. The American Academy of Child and Adolescent Psychiatry estimates there are only 8,300 such specialists in the U.S., for more than 15 million young patients.

Dr. Lindsay Irvin, a pediatrician in San Antonio, says the dearth of psychiatrists who specialize in treating young people means many young patients simply don't get the mental health treatment they need. By the time they wind up in the ER, she says, undiagnosed depression may have progressed to suicidal intent. And after leaving the ER, many are lost to follow-up.

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