Massachusetts General Hospital had to expand to accommodate the growing number of children and adults going to its emergency department for mental healthcare.
The Boston-based hospital replaced its six-bed unit for psychiatric patients with a 20-bed unit. From there, some would be admitted to the inpatient psych unit, transferred to another hospital or discharged.
But during one day in February, more than 50 behavioral health patients went to Mass General’s emergency department, which meant that 30 patients were treated in the ED, a less-than-ideal place for someone in crisis.
The average daily census of psychiatric patients exceeds the capacity of the 20-bed psychiatric unit more than 50% of the time, said Robert Seger, executive director of Mass General’s emergency medicine department.
“We’re seeing a lot more pediatric patients, who tend to stay in the ED for a long time. It’s a national phenomenon,” Seger said. “We are in a new unfortunate frontier of many psychiatric patients seeking care at the hospital. The numbers are extraordinarily high, and higher than a lot of systems can handle.”
Many hospitals, limited by a lack of mental health counselors and psychiatrists, struggle to attend to behavioral health patients, who usually stay longer than acute-care patients. Residential care and other psychiatric-oriented outpatient facilities across the country have closed or reduced their capacity, shifting an even bigger burden onto hospitals.