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Washington hospitals can't board psych patients in ER


By Beth Kutscher
Posted: August 23, 2014 - 12:01 am ET
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Starting this week, hospitals in Washington state will be prohibited from boarding psychiatric patients in emergency departments while they wait for inpatient beds to open up. The change comes as a result of a state Supreme Court ruling.

The practice of holding acutely ill psychiatric patients in EDs—sometimes in hallways and makeshift holding areas—has reached crisis levels in hospitals nationwide as inpatient psychiatric beds have disappeared. A 2012 survey from the National Association of State Mental Health Program Directors found that 10% of hospitals are boarding psychiatric patients for several weeks.

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In an Aug. 7 decision, the Washington Supreme Court ruled that the state's involuntary treatment act “does not authorize psychiatric boarding as a method to avoid overcrowding certified evaluation and treatment centers.” Gov. Jay Inslee delayed implementation of the ruling until Aug. 27.

In 2013, 10 detained psychiatric patients in Pierce County sued to block a petition that would have allowed the county to hold them for 14 additional days. The patients had been boarded in EDs or acute-care hospitals that were not certified as psychiatric evaluation and treatment centers.

A trial judge ruled that the petition was unlawful, and the Supreme Court, while acknowledging that the system is “regularly overwhelmed,” agreed that patients who are involuntarily committed have the right to be placed in a center certified for that purpose.

Follow Beth Kutscher on Twitter: @MHbkutscher


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