First few Article Sentences
Psychiatric patients awaiting treatment in hospital emergency rooms for many hours, even days – a process known as “boarding” – has become a major dilemma across the USA. A hospital in South Carolina recently made national news after holding a patient needing transfer for a stunning 38 days. With little options for care in most sites other than transfer for psychiatric hospitalization, emergency departments (EDs) are often stuck with patients acutely dangerous to themselves or others until an available inpatient bed can be obtained.
Until now, most authorities have become frustrated over a lack of options. Most proffered ideas have focused on opening up access to more inpatient psychiatric beds. The Centers for Medicare and Medicaid have recently begun a Demonstration Project to allow more private psychiatric hospitals to accept Medicaid patients. Yet such approaches still rely on the concept that most acute psychiatric care requires inpatient hospitalization – a practice roughly equivalent to hospitalizing everyone who came to the ED with chest pain. Little attention has been paid to confronting the problem head on, by treating patients at the emergency level of care.