Getting psychiatric patients out of ERs

New resolve may lead to faster treatment, solution to old crowding problem

Friday, Oct. 9, 2009 | 2 a.m.

Recession fills area's ER beds with mentally ill (6-8-2009)
A chance at a real life (1-29-2008)
State OKs funds for mental health treatment facility (8-25-2005)
No longer under the radar (3-25-2005)
Groups appeal to lawmakers to address mental health needs (10-5-2004)
Crisis continues for mentally ill patients (8-25-2004)
Editorial: Mental health crisis needs a permanent fix (7-13-2004)
Plan for mental patients approved (10-30-2002)
Plan for mentally ill is questioned (8-19-2002)

Division of Mental Health and Development Services

Five years ago then-Clark County Manager Thom Reilly declared a crisis when about a third of the valley’s emergency rooms were filled with psychiatric patients, most of whom were waiting to be transferred to the state’s mental health hospital.

In June a regional coalition of organizations that deals with mental health issues held its first meeting in two years, in part because the day-to-day numbers of psychiatric patients in emergency room beds appeared to be exceeding those that triggered the emergency five years earlier.

Today a separate group is trying to straighten out a few long-standing obstacles to dealing with the issue. Chief among them is that the valley’s 14 acute-care hospitals and the state Department of Mental Health and Developmental Services have never agreed on how to screen psychiatric patients as required by law, how to transfer them to psychiatric care, or even how to count them.

Some hospitals don’t even share their counts with state or county officials.

When these problems are added to an ongoing shortage of psychiatric services, the result is that the mentally ill, many suicidal, often languish in emergency rooms without help, and the true size of the problem remains elusive, says Bill Welch, president of the Nevada Hospital Association.

Fortunately, all that may be about to change.

Welch’s group and state officials have been meeting for about two months to develop new policies and procedures for addressing the problems. The goal is for the valley’s hospitals and the state to adopt a uniform system for treating the mentally ill, resulting in better physical and psychiatric care.

In the decade that Welch has led the association, he said, hospitals have never used the same procedures for medically screening patients who arrive at emergency rooms needing treatment for psychiatric problems. As a result, hospitals don’t pass along the same screening results when those patients are transferred to the state mental health hospital, meaning the state’s medical staff gets different kinds of information on different patients, depending on where they come from. Sometimes, time is lost in the search for more information that may be needed for ongoing treatment, Welch said.

Uniform screening at the acute-care hospitals will improve patient flow through the emergency room — and help free up beds for those who need them, Welch said.

Welch said there also has been no uniform system for transferring patients to the state’s hospital at Southern Nevada Adult Mental Health Services in Las Vegas, or for tracking the process. This sometimes creates further delays in getting patients into psychiatric treatment.

Last, he said, each participant in the process has had its own way of classifying psychiatric patients, depending on where they are in the sequence of entering the hospital, screening and transferring. This has to stop because “we need to know the volume of these patients to assess the problem accurately,” Welch said. In the past, he recalled, different agencies have debated the numbers of psychiatric patients in the presence of legislators, making it harder to reach decisions about funding more services.

Welch said this knotty problem has persisted mostly because “there hasn’t been willingness to come to a consensus.” Now, he said, “we all have to leave our egos at the door and concede a little.”

Comments
Print
E-mail
Share
- Facebook
- Fark
- Digg
- Reddit
- Stumble
Tweet

Discussion: comments so far…

Comments are moderated by Las Vegas Sun editors. Our goal is not to limit the discussion, but rather to elevate it. Comments should be relevant and contain no abusive language. Comments that are off-topic, vulgar, profane or include personal attacks will be removed. Full comments policy. Additionally, we now display comments from trusted commenters by default. Those wishing to become a trusted commenter need to verify their identity or sign in with Facebook Connect to tie their Facebook account to their Las Vegas Sun account. For more on this change, read our story about how it works and why we did it.

Only trusted comments are displayed on this page. Untrusted comments have expired from this story.

No trusted comments have been posted.

By JSTACK

Oct. 9, 2009

3:51 a.m.

Flag

And if its not the mentally ill, the ER's are filled with illegal immigrants that use the ER departments as a doctor's office and then skip out on the bill, making me pay out more for my insurance.
By Planetearthcalling

Oct. 9, 2009

4:44 a.m.

Flag

With the county managers long and unblemished history of running the county hospital straight into the ground at great expense to the taxpayer, I'm not the least bit surprised to hear local hospitals in the area are unwilling to even talk to that bozo. Put him on hold he'll go away eventually.
I wouldn't have anything to do with an idiot like that either.
By afveteran

Oct. 9, 2009

7:22 a.m.

Flag

There isn't any doubt that Illegal aliens, especially of the Mexican variety, place a tremendous burden on the system in Nevada, as well as other heavily Mexican populated states.
California's once great hospital system has gone broke because of them. The Border Patrol has been misused, they haven't been allowed to do their job: deportations.
By mikeg

Oct. 9, 2009

7:24 a.m.

Flag

So uniform screening will solve the problem of too many mentally ill in Vegas? Lol ok whatever. You'd have trouble finding a sane person in this city - doctors included.