Gaps in Mental Health Treatment Means Psychiatric Patients Rely on ER – Even Youth

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Gaps in Mental Health Treatment Means Psychiatric Patients Rely on ER – Even Youth

According to the Centers for Disease Control and Prevention, as many as 1 in 5 children suffer every year from a psychiatric illness. However, a shortage of both specialists and facilities offering treatment means that many children will left behind, so to speak.

In addition, research presented at the annual meeting of the American College of Emergency Physician found that people with mental illness rely more or the emergency department for treatment than those who are physically ill. They also tend to be held in the ER longer than other persons, and are more often admitted to the hospital.

Data was compiled by the National Hospital Ambulatory Medical Care Survey, which analyzed mental health visits to emergency departments between 2001-2011.

Researchers obtained these statistics:

  • Around 6% of ER patients, of any age, had a psychiatric illness
  • Over 20% of those patients were subsequently admitted to the hospital (compared to 13% of patients with physical symptoms)
  • Approximately 11% of psychiatric patients required transfer to another facility (compared to just 1.4% of patients with physical symptoms)
  • Around 23% of psychiatric patients stayed in emergency care for over 6 hours, and 1.3% stayed for more than 24 hours.
  • About 22% of psychiatric patients lacked insurance coverage, compared to 15% of persons treated for physical ailments.

These figures are likely a reflection of the lack of effective outpatient treatment, and also include repeat visits when adequate care is not available for follow up. In essence, patients get caught in a loop upon release, and keep returning because they aren’t being diverted to into the proper channels.

And now we know there is a large number of youth being affected by the gaps in mental health care, as well.

Other findings include:

  • The most serious ill psychiatric patients spend more time in the emergency room.
  • Patients with bipolar disorder, depression, psychosis, or co-occurring condition are more likely than others to stay in the ER over 24 hours.
  • 20% of ER doctors stated that they have encountered psychiatric patients needing hospitalization that had to wait 2-5 days before a bed could be found.

Currently, there is a nationwide shortage of inpatient beds for patients with mental illness. Even those who do get inpatient care sometimes wait days or weeks.

These delays hurt both the psychiatric patients, doctors, and others, particularly those who find their way into busy, cramped emergency facilities. Not to mention the ER is not a good place for people with mental illness in general.

Finally, youth are among the least likely to get good treatment after discharge, due to a lack of resources. According to the American Academy of Child and Adolescent Psychiatry, only about 8,300 child psychiatric specialists are practicing in the U.S. To put that in perspective, with 15 million young patients, that’s more than 1800 persons per clinician.

And ultimately, this means that if they do receive follow-up treatment, it will likely be in pediatrics or family practice – an area where few doctors been trained to properly utilize psychotropic medications.


In general, the problem with insufficient mental health care is sizable, and has been for some time. This is mainly due to a lack of resources and funding.

However, make no mistake – there is still a huge stigmatization of mentally ill patients, and they are often viewed as having less valid health concerns. This approach to mental health care is devastating for youth, but also the more 57 million Americans diagnosable with a mental illness each year.

~ G. Nathalee Serrels, M.A., Psychology

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