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Tackling emergency department overcrowding with telepsychiatry

February 06, 2023
Emergency Medicine
Andy Flanagan
By Andy Flanagan

Often crowded, chaotic, and understaffed with long wait times, hospital emergency departments are not the ideal setting in which to deliver mental health services to patients. But, on average, one in eight ED visits in the U.S. is related to a mental health or substance use disorder. Hospitals have seen a 24% spike in mental health ED visits for children aged 5 to 11 and a 31% increase for adolescents aged 12 to 17. This increase in behavioral health visits places stress on EDs, which are better designed and staffed to assess and treat surgical and medical needs and often lack the staff and resources to handle behavioral health issues.

Recently, EDs have reached a breaking point due to a lack of available inpatient beds and staffing shortages. Rather than letting a patient in crisis leave, they choose psychiatric boarding, in which patients are held for long periods of time before receiving treatment. According to the Joint Commission, psychiatric boarding can increase stress on patients who may already be in crisis. Additionally, ED boarding can:

1. Consume scarce ED resources and increase pressure on staff
2. Delay mental health treatment that could mitigate the need for inpatient stay
3. Increase ED crowding
4. Extend wait times for all patients in the ED
5. Pose a significant financial impact on ED reimbursement

How telepsychiatry improves care in the ED
Telepsychiatry can enable EDs to deliver needed mental health care without additional resources or personnel. Telepsychiatry delivered by a qualified vendor partner gives hospital EDs the ability to provide patients with high-quality psychiatric care through virtual visits. Patients do not have to wait hours to receive treatment from an ED physician or an in-person consultation from a psychiatric provider, which, according to one study, can reduce their length of stay in the ED by as much as 62%.

Telepsychiatry also reduces the burden on attending physicians and ED staff by giving them access to psychiatric providers who can quickly assess and treat patients, freeing up ED team to focus on patients who come in for medical and surgical needs.

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