The Impact of Integrating Behavioral Health Care in the Emergency Department at HMC.

Abstract

Patients experiencing psychiatric emergencies often require resources not available at the hospital to which they present and frequently require transfer to an appropriate psychiatric facility as it is the case at the Emergency department of HGH. This typically involves being held in the Emergency Department (ED) until a psychiatric bed is available. Boarding of psychiatric patients, (defined as a length of stay greater than four hours after medical clearance), is ubiquitous throughout emergency departments nationwide (USA).1 The limited number of inpatient psychiatric beds combined with the increase in mental health related ED visits have amplified the number of patients boarding in the ED.1 Our Emergency department established in 2014 an innovative and pioneering psychiatric liaison service based in ED, it is the first in the Gulf Area. In this study we are set to look at the difference in response time, boarding time, and disposition during the last four month compared to a similar period of a previous year. The preliminary results indicate a substantial decrease of total admissions, a similar decrease in overnight boarding and a shorter turnaround time to disposition. more results and parameters will be discussed as well as different models of implementation. Conclusion having a dedicated psychiatric team embedded in a busy emergency department is conducive to providing a higher quality of mental health care, decrease the adverse occurences associated with boarding the severely mentally ill.