Survey: 8 in 10 ER Docs Say Mental Health System Is Not Working for Patients

Emergency Physicians, Nurses, Psychiatrists and Patient Advocates Unite to Change Treatment of Psychiatric Emergencies. In NYC, the de Blasio Administration Focuses On Maternal Depression.

More than 80 percent of emergency physicians say the mental health care systems in their regions are not working for patients, according to a new survey of nearly 1,500 emergency physicians.  To help address these challenges, more than 30 of the nation’s top mental health and emergency medicine leaders are launching  the Coalition on Psychiatric Emergencies, also known as “COPE,” aimed at improving patient care in emergency departments during psychiatric crisis.

“More people are coming to emergency departments for help during psychiatric emergencies,” said Michael Gerardi, MD, COPE Steering Committee Chair and immediate past president of the American College of Emergency Physicians.  “It’s time we think about doing things differently. We want to provide the best care for all our patients and reduce health care costs.”

Recently, the de Blasio Administration released ThriveNYC, a white paper detailing the size and scope of the mental health crisis in New York City. ThriveNYC is seen by the de Blasio Administration as the first step towards building a mental health system that can support the well-being of the thousands of New Yorkers dealing with mental health challenges. One of the key initiatives is universal screening for maternal and post-partum depression.

“Screening and treatment for maternal depression should be a part of routine care,” said Mayor Bill de Blasio last November. Maternal and postpartum depression often go undiagnosed, but physicians now recognize that to treat a patient holistically they must be attentive to mental health as well as physical health. 

The de Blasio Administration has been roundly criticized for focusing on depression and addiction services, rather than schizophrenia, bipolar disorder and those other serious psychiatric disorders that overwhelm city hospitals, law enforcement and the court system.

Approximately 1 in 25 adults in the U.S.—13.6 million—experience a serious mental illness in any given year that substantially interferes with one or more major life activities. At least one in ten women suffers from depression – at least 10,000 women a year in New York City. Maternal depression can negatively affect both infant health and the mother’s lifelong mental health.

“ThriveNYC is a something-for-everyone plan designed to encourage the mental well-being of all New Yorkers, as opposed to delivering treatment to the most seriously mentally ill,” wrote D.J. Jaffe, executive director of MentalIllness.org, in City Journal. Jaffee also noted that the Mayor’s plan does not include funding to expand treatment beds for the severely mentally ill.

According to the CDC, schizophrenia and other psychiatric disorders have the highest rate of ER visits of any chronic condition.

Through a unique collaboration, the Coalition on Psychiatric Emergencies will focus on developing a more unified treatment model and improving the treatment experience for both patients and health care providers.

In New York City, it appears that the mental health system is not working for seriously mentally ill patients. There has been a steady rise in the number of mentally ill homeless people on city streets. Police Commissioner Bill Bratton said that the police are forced to step when the mental health system fails.

The ACEP survey comes on the heels of two other national surveys that show the current model isn’t working for either emergency staff or patients. A recent Emergency Nurses Association (ENA) study found a majority of emergency room nurses report a shortage of tailored education and training, which makes the care of patients with mental health issues more difficult. From a patient point of view, a recent National Alliance on Mental Illness (NAMI) survey found that 44 percent of patients were unhappy with their experience: 38 percent waited more than 7 hours to see a mental health professional, and in 21 percent of cases the wait was more than 10 hours.