Mental health in America

Stat News recently ran an interesting article that offers a somber detail of the state of mental health in America. As if the healthcare industry isn’t complex enough — the intersection of mental health and physical health is presenting new issues that will take serious consideration to solve. The article’s author, Anna Zink, works as the medical director for emergency medicine at the Mat-Su Regional Medical Center in Palmer, Alaska. She details her experience with the emergency room being used for mental health issues:

When I walk through my hospital’s emergency department, I’m sometimes overwhelmed by the number of people languishing there as they wait for help with a mental health issue, like the woman clutching her chest as if she’s having a heart attack but is really suffering from a panic attack. It’s her third time here in a week.

She is just one of the hundreds of patients who will be admitted this year to my emergency department in the Mat-Su Regional Medical Center in Palmer, Alaska, experiencing psychiatric emergencies.

Many stay in the emergency department for hours; some even stay there for a few days. The practice, called psychiatric boarding, occurs when an individual with a mental health condition is kept in an emergency department because no appropriate mental health care is available. It’s rampant around the country.

According to the article, 1 in 5 adults, nearly 44 million people suffer from a mental health issue yearly. The author offers her explanation of why the emergency room is the most popular destination for those suffering from mental health issues:

Part of the answer is the function of the emergency department in today’s health care system. I think of it as an overflow tank. When one part of the health care system fails, problems trickle down and come to rest in the emergency department. The tremendous fear and stigma associated with mental health makes the problem worse, as many patients fail to seek help at the onset of a mental health issue. There are financial barriers, too. Primary care doctors, for example, traditionally couldn’t bill for the treatment of a mental health disorder, though that is changing.

The effect is a surge in patients seeking providers who can “fix” or “help” them on demand in the emergency room. But the hospital emergency department isn’t designed to address ongoing behavioral health issues that require personalized, psychiatric interventions. When a patient isn’t an immediate threat to his or her community, they’re eventually discharged but left unchanged and unaided — and essentially ready to repeat the cycle.

Zink proposes a few solutions that she believes could reverse this phenomenon. She says that hospitals need better processes to identify and transfer these patients to psychiatric facilities. Connecting hospitals and behavioral health units would make this process easier. Further, she proposes opening up access to mental health facilities in order to treat this issue before having to resort to the emergency department.

This personal account raises some serious questions about the way we as a country are approaching the widespread mental health issue. Do we have enough resources for those who need this assistance with mental health issues? What is the role of the hospital in making sure these patients get the correct type of care? Is there something society needs to change in order to bring down the number of people who suffer from this type of illness? What can we as citizens do to help out those suffering from mental health illnesses in order to relieve some of the burden on our health care system?

Jordan Roberts / Health Policy Analyst

Jordan joined the Locke Foundation in the summer of 2018 as Health Care Policy Analyst. He analyzes state and national health policy issues with an eye toward removing governm...

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