Hospital ER's see long waits for mentally ill patients

BRUNSWICK, Maine (NEWS CENTER) -- When someone is experiencing a mental health crisis, there are often few options. Police are often the first ones called to the scene and the confrontations sometimes end violently. For those who decide to go get medical help, they will sometimes go to the emergency and end up waiting for days for any help.

The problem, it turns out, is common at most Maine hospitals. At the small emergency room at Lincoln Health's Miles campus in Damariscotta, ER director Dr. Tim Fox said they regularly will have mentally ill patients waiting a day or longer for an available "psychiatric bed" at one of the approximately nine hospitals that have them.

"There's frequently no bed available for patients," said Fox, "and some can wait for days in the ER."

Jane Moore, a counselor who also lives with her own mental illness, said she has experienced the wait at other hospitals.

"It is inhumane being there three to five days, often on a gurney, maybe you have a chair, in a locked room usually or a room with a guard," she said.

Physicians and mental health advocates said many patients are treated in hospital ER's and are seen promptly by a counselor. They will perhaps be prescribed drugs or other treatment and sent home. But some of those people need in-patient hospital care, which means specialized "psych" beds, and those are typically hard to find. Even at hospitals that do have those type of beds, such as Midcoast Hospital in Brunswick, long emergency room waits occur.

Lori Allen, R.N., who is nurse director for the emergency room at Midcoast, said it is a growing problem.

"Since 2010 we've had a 242 percent increase in the number of patients who present in the emergency department with behavioral health complaints," said Allen.

Medical and mental health experts said the reasons for the long waits are complex, like the state's entire mental health system. The experts have a range of opinions on the need for more beds. Some said it is simply a lack of beds, while others said the problem is chronic underfunding of the whole system. Still, others pointed out that budget and insurance changes have caused some patients to no longer be able to afford their medications. Experts said that patients and their families often don't understand how to access the system, including separate "crisis intervention beds", which can be available when hospital beds are not.

The Maine Hospital Association said the problem of long waits in emergency rooms is one of several that have become a major concern for hospitals. An association spokesman said there are several bills in the legislature that could address some pieces of the issue

The association and the National Alliance for the Mentally Ill also said current efforts to increase staffing at the Riverview Hospital could also help open up a few beds.

Jenna Mehnert of NAMI Maine said the system does need more beds, but presently lacks the needed data to determine how many and what type of beds are actually needed. She said it appears the greatest need is for beds for violent or aggressive patients, elderly mentally ill people and juveniles. However, any such increase in mental health bed capacity is likely to take a considerable amount of time, because of the usual Certificate of Need process involved for hospital expansions.


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