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ER Docs Report Large Increase In Psychiatric Patients

The impact of Medicaid budget cuts is being felt by patients and physicians in emergency rooms.

Nearly two-thirds (61 percent) of emergency room (ER) physicians who responded to a recent survey reported an increase in the number of patients who had psychiatric emergencies in the previous six to 12 months.

The American College of Emergency Physicians (ACEP) undertook the survey in March 2004 in partnership with APA, the National Mental Health Association, and the National Alliance for the Mentally Ill.

The survey was conducted online, after 340 respondents replied to an invitation in the ACEP newsletter.

Two-thirds of the respondents (67 percent) have noticed more psychiatric patients "boarding" in the emergency room.

According to 81 percent of the respondents, the increase in boarders has a negative effect on the care of other patients. Among the problems are decreased availability of ER staff for other patients, longer waits for patients in the waiting room, and patient frustration.

Eleven percent of the respondents said they knew of nowhere but the emergency room for patients with psychiatric emergencies to receive care.

Forty-eight percent of respondents said that the number of psychiatric beds in the region had decreased in the preceding six to 12 months. Less than a quarter (24 percent) said the number had not decreased, and the remainder did not know.

More than 90 percent of the respondents who have seen an increase in the number of patients with psychiatric emergencies attribute the change to state budget cuts to Medicaid, decreasing number of psychiatric beds, or a combination of the two.

"The findings underscore the serious consequences that state budget cuts to programs like Medicaid are having not only for people with mental illness, but for anyone who might find himself or herself in an emergency room," said APA Medical Director James H. Scully Jr., M.D.

A press release on the survey, titled "Emergency Departments See Dramatic Increase in People with Mental Illness Seeking Care," is posted online at <www.psych.org/news_room/press_releases/emergencystudy06032004.pdf>.

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