Caring for Psychiatric Patients: The Ongoing Challenge

Nearly 60 million Americans suffer from mental illness.  The deinstitutionalization of mentally ill patients starting in the 1960s and inadequate financing for community-based care has left many Americans without access to quality mental healthcare.  In addition, hospitals across the country have sharply cut back on money-losing psychiatric beds.  All of these factors have created a strain on hospital emergency departments (EDs), which are the last resort for patients, their families and public-safety officials dealing with people suffering from acute mental illness.

The dramatic rise in emergency patients with chronic psychiatric conditions is a national crisis, with millions of people across the U.S. seeking care in our nation’s overcrowded and often overwhelmed EDs.  For many years, hospitals in the U.S. have been struggling to meet the needs of psychiatric patients seeking help.  Boarding these fragile patients in the ED is a Band-Aid solution to a complex problem that is only getting worse.  Health systems recognize that they need to address the psychiatric boarding problem because EDs bring in a lot of paying patients. Delays in serving them because of the boarding of psychiatric patients can hurt revenue.

With the total number of psychiatric inpatient beds plummeting nationally, hospitals are devising innovative ways of handling mentally ill patients who come to the emergency department as an alternative to “boarding” them in holding rooms and hallways while they await treatment.  These strategies include collaborating with other hospitals to place psychiatric patients in open beds, using separate psychiatric EDs, setting up crisis triage centers, and referring patients to residential treatment centers.  Hospitals also are investing in crisis-oriented outpatient care as another way to steer patients away from the emergency room, since a lot of folks that are being seen may not need a hospital bed.

BLDD Architects is currently helping Genesis Health System implement their comprehensive expansion of their behavior health services.  BLDD has designed the new Genesis Outpatient Crisis Stabilization Unit as well as the new 26-bed Geriatric Inpatient Unit, which will serve individuals ages 55+ who demonstrate acute mental illness.

Steve Oliver, AIA, NCARB, LEED AP
Director of Healthcare

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