Behavioral Health Patient Boarding in the ED

Community Based Mitigation Strategy for Violence in the ED

 Hospitals work in collaboration with communities, region or state to develop strategies to eliminate psychiatric boarding through community based approaches-

1. Expansion of psychiatric outpatient services. Basic needs and prescription drugs can be managed through these service at a lower cost. This will increase accessibility to psychiatric as well as substance abuse care.³⁶

2. Mental health provider shortage can be dealt by encouraging more students to join psychiatric residency. This can be achieved by loan repayment funding of medical students choosing psychiatric residency. This will increase the number of doctors and subsequently accessibility to care.³²

3. The Affordable Care Act provides additional benefits to states by creating “health homes”. These homes provide integrated and coordinated primary care, behavioral health service, acute psychiatric care and long term care for patients suffering from chronic conditions.³⁶

4. Developing community crisis services can be vital in providing 24/7 psychiatric emergency services. Other services can include “mobile crisis team, crisis residential services, crisis stabilization unit; voluntary emergency residential unit; crisis counseling unit”.^36,39

Conclusion:

Emergency Departments are the safety net of the healthcare system. Maintaining safe environment for the delivery of services should be a priority for hospital administrators. With increase in the utilization of the emergency services by psychiatric patients, boarding is a big health delivery problem for both USA and Canada. Increased demand and stressful work environment poses a big question for the security of healthcare workers in Emergency Departments. Within the available limited capacity, restructuring the delivery model by providing safer waiting areas for psychiatric health patients is the need of the hour. Involvement of hospital leadership as well as adherence to all applicable regulatory guidelines is vital for carrying out positive changes for creating safer work environment and reducing the cases of workplace violence.

References:

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Author

Himi Mathur

Ms. Mathur is a graduate public health student concentrating in Health Policy and Management from Boston University, School of Public Health. She has an undergraduate degree in dentistry with research experience in substance abuse and primary health.  She has two years of experience as a project manager with a non-profit organization implementing measures for increasing access to primary health care.

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