Code Overdue: Psychiatric Care in the ED

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Code Overdue: Psychiatric Care in the Emergency Department

Hartej Gill, PhD(c)

Disclosures

October 25, 2021

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Emergency medicine clinicians and emergency departments offer first-line care for people requiring immediate medical attention. In the United States, there are more than 100 million annual ED visits.

At one time or another, many of us have found ourselves waiting for emergency care. The long wait times and delays in care have increased the likelihood of short-term adverse events and pose a significant barrier to receiving timely medical intervention. However, whether it is a broken arm or a life-threatening injury, the ED is the first — and often, only — option for rapid care.

This frantic pace juxtaposed with the long wait times is characteristic of people's perception of the ED, one embedded in popular American culture through shows such as Grey's Anatomy. The ED is typically portrayed as a frenetic and chaotic environment. However, emergency rooms have also become a first-line option for individuals requiring mental health care.

Between 2007 and 2016, approximately 10% of ED visits were for mental health or substance use–related disorders (SUD). In children, approximately 5% of ED visits were for mental health–related concerns. Notably, 15%of the mental health–related ED visits resulted in hospitalization or prolonged care. Over the past decade, the number of mental health–related ED visits has

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