By Corinne Segal
PBS News Hour
September 18, 2016
Here is an excerpt:
Health workers and lawmakers are working to accommodate patients like Durant as America endures a suicide surge, with suicide deaths rising from 29,000 people to 43,000 people between 1999 and 2014. Some have tried to increase the number of psychiatric beds available to suicidal patients, a disappearing resource in recent years that forces patients like Durant to wait longs hours for care. Meanwhile, others are assessing whether the hospital is even the right place to start considering treatment.
In recent decades, “We closed thousands of beds and we didn’t cure mental health,” David Mattodeo, Executive Director of the Massachusetts Association of Behavioral Health Systems, said. “The problem didn’t go away.”
The article is here.
Showing posts with label Emergency Psychiatric Care. Show all posts
Showing posts with label Emergency Psychiatric Care. Show all posts
Monday, October 10, 2016
Thursday, December 10, 2015
Decreasing mental health services increases mental health emergencies
Science Daily
Originally published November 20, 2015
Countywide reductions in psychiatric services -- both inpatient and outpatient -- led to more than triple the number of emergency psychiatric consults and 55 percent increases in lengths of stay for psychiatric patients in the emergency department. The before and after study of the impact of decreasing county mental health services was published online in Annals of Emergency Medicine ('Impact of Decreasing County Mental Health Services on the Emergency Medicine').
"As is often the case, the emergency department catches everyone who falls through the cracks in the health care system," said lead study author Arica Nesper, MD, MAS of the University of California Davis School of Medicine in Sacramento. "People with mental illness did not stop needing care simply because the resources dried up. Potentially serious complaints increased after reductions in mental health services, likely representing not only worse care of patients' psychiatric issues but also the medical issues of patients with psychiatric problems."
The entire article is here.
Originally published November 20, 2015
Countywide reductions in psychiatric services -- both inpatient and outpatient -- led to more than triple the number of emergency psychiatric consults and 55 percent increases in lengths of stay for psychiatric patients in the emergency department. The before and after study of the impact of decreasing county mental health services was published online in Annals of Emergency Medicine ('Impact of Decreasing County Mental Health Services on the Emergency Medicine').
"As is often the case, the emergency department catches everyone who falls through the cracks in the health care system," said lead study author Arica Nesper, MD, MAS of the University of California Davis School of Medicine in Sacramento. "People with mental illness did not stop needing care simply because the resources dried up. Potentially serious complaints increased after reductions in mental health services, likely representing not only worse care of patients' psychiatric issues but also the medical issues of patients with psychiatric problems."
The entire article is here.
Saturday, June 2, 2012
Outpatient Care of Young People After Emergency Treatment of Deliberate Self-Harm
By Dennis Thompson
MedicineNet.com
Originally published on May 25, 2012
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.
But researchers now are questioning whether enough is being done to reach out to these young people and help them before they do themselves irreparable damage.
One study this year found that six of every 10 adolescents who went to an emergency room for treatment after harming themselves were released without receiving a mental health assessment or any follow-up mental health care. The findings were reported in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
Here is a link to the summary of this article.
The original research is below.
by Jeffrey Bridge, Steven Marcus, and Mark Olfson
Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 2 , Pages 213-222.e1, February 2012
MedicineNet.com
Originally published on May 25, 2012
Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.But researchers now are questioning whether enough is being done to reach out to these young people and help them before they do themselves irreparable damage.
One study this year found that six of every 10 adolescents who went to an emergency room for treatment after harming themselves were released without receiving a mental health assessment or any follow-up mental health care. The findings were reported in the February issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
Here is a link to the summary of this article.
The original research is below.
by Jeffrey Bridge, Steven Marcus, and Mark Olfson
Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 2 , Pages 213-222.e1, February 2012
Objective
Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm.Method
A retrospective longitudinal cohort analysis was conducted of national 2006 Medicaid claims data supplemented with the Area Resource File and a Substance Abuse and Mental Health Services Administration Medicaid policy survey of state policy characteristics focusing on ED treatment episodes by youth 10 to 19 years old for deliberate self-harm (n = 3,241). Rates and adjusted risk ratios (ARR) of discharge to the community, mental health assessments in the ED, and outpatient visits during the 30 days after the ED visit were assessed.Results
Most patients (72.9%) were discharged to the community. Discharge was inversely related to recent psychiatric hospitalization (ARR 0.75, 99% confidence interval [CI] 0.63–0.90). Thirty-nine percent of discharged patients received a mental health assessment in the ED and a roughly similar percentage (43.0%) received follow-up outpatient mental health care. Follow-up mental health care was directly related to recent outpatient (ARR 2.58, 99% CI 2.27–2.94) and inpatient (ARR 1.33, 99% CI 1.14–1.56) mental health care and inversely related to Hispanic ethnicity (ARR 0.78, 99% CI 0.64–0.95) and residence in a county with medium-to-high poverty rates (ARR 0.84, 99% CI 0.73–0.97).Conclusions
A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care.
Psychiatric Patients Languish In Emergency Rooms
By Eric Whitney
Colorado Public Radio in conjunction with Kaiser Health News
Originally published May 31, 2012
Last fall Kathy Partridge got a phone call from a local emergency room, telling her that her daughter, Jessie Glasscock, was there -- and was OK. Glasscock had gone missing overnight. She was away at college, and had a history of manic episodes. Police had found her in a dumpster and brought her to the ER for her own safety. It was a huge relief for her mother – but she was completely surprised by what happened next.
"It sort of seemed like, well, they'll stabilize her, help her get back on her meds and she'll pick up her pieces. Instead, I went down to this emergency room and just found her by herself, basically locked in a closet," Partridge said.
The "closet" was actually an exam room, but Partridge explains it was small, windowless, and the only furniture was a stainless steel bed. Her daughter waited there, wearing nothing but a hospital gown, without treatment or a decent meal for 24 hours. Partridge was shocked to learn there was no place for her daughter to get treatment. "There was not a single psychiatric bed to release her in in the entire state of Colorado," she says.
The entire story is here.
Colorado Public Radio in conjunction with Kaiser Health News
Originally published May 31, 2012
"It sort of seemed like, well, they'll stabilize her, help her get back on her meds and she'll pick up her pieces. Instead, I went down to this emergency room and just found her by herself, basically locked in a closet," Partridge said.
The "closet" was actually an exam room, but Partridge explains it was small, windowless, and the only furniture was a stainless steel bed. Her daughter waited there, wearing nothing but a hospital gown, without treatment or a decent meal for 24 hours. Partridge was shocked to learn there was no place for her daughter to get treatment. "There was not a single psychiatric bed to release her in in the entire state of Colorado," she says.
The entire story is here.
Wednesday, November 2, 2011
Pediatric Emergency Department Visits for Psychiatric Care on the Rise
American Academy of Pediatrics
News Release
Published: October 14, 2011
BOSTON – Pediatric patients, primarily those who are underinsured (either without insurance or receiving Medicaid), are increasingly receiving psychiatric care in hospital emergency departments (EDs), according to an abstract presented Friday, Oct. 14, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Boston.
Researchers reviewed ED data, including patient age, sex, race, ethnicity, insurance status, and type of care received, from the National Hospital Ambulatory Medical Care Survey, between 1999 through 2007. The study, “Disproportionately Increasing Psychiatric Visits to the Pediatric Emergency Department Among the Underinsured,” found that over eight years, 279 million pediatric patients were seen in U.S. EDs, of which 2.8 percent were for psychiatric visits. The prevalence of psychiatric visits among pediatric patients increased from 2.4 percent in 1999 to 3 percent in 2007. The underinsured group initially accounted for 46 percent of pediatric ED visits in 1999, growing to 54 percent in 2007.
The results of this study are important for several reasons. First, the data show that, as anticipated, psychiatric visits by children to emergency departments continue to increase in number and as a percentage of all patients being seen in emergency departments, said lead study author Zachary Pittsenbarger, MD. “A second, and more novel finding, is that one group in particular is increasing beyond any other socio-demographic group, and that is the publicly insured.” he said.
“It has been found previously that the publicly insured have fewer treatment options and longer wait times for psychiatric disorders when not hospitalized,” Dr. Pittsenbarger said. “This new finding argues that limited outpatient mental health resources force those patients to seek the care they need in the emergency department.”
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults. For more information, visit www.aap.org.
News Release
Published: October 14, 2011
Researchers reviewed ED data, including patient age, sex, race, ethnicity, insurance status, and type of care received, from the National Hospital Ambulatory Medical Care Survey, between 1999 through 2007. The study, “Disproportionately Increasing Psychiatric Visits to the Pediatric Emergency Department Among the Underinsured,” found that over eight years, 279 million pediatric patients were seen in U.S. EDs, of which 2.8 percent were for psychiatric visits. The prevalence of psychiatric visits among pediatric patients increased from 2.4 percent in 1999 to 3 percent in 2007. The underinsured group initially accounted for 46 percent of pediatric ED visits in 1999, growing to 54 percent in 2007.
The results of this study are important for several reasons. First, the data show that, as anticipated, psychiatric visits by children to emergency departments continue to increase in number and as a percentage of all patients being seen in emergency departments, said lead study author Zachary Pittsenbarger, MD. “A second, and more novel finding, is that one group in particular is increasing beyond any other socio-demographic group, and that is the publicly insured.” he said.
“It has been found previously that the publicly insured have fewer treatment options and longer wait times for psychiatric disorders when not hospitalized,” Dr. Pittsenbarger said. “This new finding argues that limited outpatient mental health resources force those patients to seek the care they need in the emergency department.”
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