Some psych patients wait days in hospital ERs

Some psych patients wait days in hospital ERs
Thursday, July 03, 2008 5:09:10 PM

NEW YORK(AP)

When staffers at a Brooklyn hospital spotted a middle-aged woman lying face-down on a waiting room floor last month, it hardly seemed like cause for alarm.

The sight, after all, was common in the psychiatric emergency room at Kings County Hospital Center. The unit is so routinely backed up with people waiting hours, or even days, for services that patients often spend the night nodding in chairs or sprawled in a corner.

It took an hour before a nurse realized the prone woman was in trouble. By then, she was dead.

Security camera footage of the woman drew outrage when it became public this week. Experts say it is also an extreme symptom of a crisis occurring in hospitals nationwide.

Emergency rooms, they say, have become all-purpose dumping grounds for the mentally ill, with patients routinely marooned a day or more while health care workers try to find someone to care for them.

A survey of hundreds of U.S. hospitals released last month by the American College of Emergency Physicians found that 79 percent reported that they routinely "boarded" psychiatric patients in their waiting rooms for at least some period of time because of the unavailability of immediate services.

One-third reported that those stays averaged at least eight hours, and 6 percent said they had average waits of more than 24 hours for the next step in a patient's care.

"We try to find a place to put them," said Dr. David Mendelson, an emergency physician in Dallas who wrote the ACEP report. Ideally, he said, that place would be a quiet spot with one-on-one nursing care, but that doesn't always happen.

"Unfortunately, sometimes the only thing we can do is restrain them, or medicate them," he said.

There are many reasons for the delays, which vary from city to city, but doctors said they usually boil down to one thing: a lack of available mental health services.
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