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{
    "pk": 19175,
    "title": "Impact of the Mental Health Care Delivery System on California Emergency Departments",
    "subtitle": null,
    "abstract": "Introduction: This is an observational study of emergency departments (ED) in California to identify factors related to the magnitude of ED utilization by patients with mental health needs.Methods: In 2010, an online survey was administered to ED directors in California querying them about factors related to the evaluation, timeliness to appropriate psychiatric treatment, and disposition of patients presenting to EDs with psychiatric complaints.Results: One hundred twenty-three ED directors from 42 of California’s 58 counties responded to the survey. The mean number of hours it took for psychiatric evaluations to be completed in the ED, from the time referral was placed to completed evaluation, was 5.97 hours (95% confidence interval [CI], 4.82–7.13). The average wait time for adult patients with a primary psychiatric diagnosis in the ED, once the decision to admit was made until placement into an inpatient psychiatric bed or transfer to an appropriate level of care, was 10.05 hours (95% CI, 8.69–11.52). The average wait time for pediatric patients with a primary psychiatric diagnosis was 12.97 hours (95% CI, 11.16–14.77). The most common reason reported for extended ED stays for this patient population was lack of inpatient psychiatric beds.Conclusion: The extraordinary wait times for patients with mental illness in the ED, as well as the lack of resources available to EDs for effectively treating and appropriately placing these patients, indicate the existence of a mental health system in California that prevents patients in acute need of psychiatric treatment from getting it at the right time, in the right place. [West J Emerg Med. 2012;13(1):51–56.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "emergency psychiatric services"
        },
        {
            "word": "mental health services"
        },
        {
            "word": "LPS act"
        },
        {
            "word": "Health Services Research"
        },
        {
            "word": "Psychiatric and Mental Health"
        }
    ],
    "section": "Behavioral Emergencies",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5k47h5vf",
    "frozenauthors": [
        {
            "first_name": "Ashley",
            "middle_name": "",
            "last_name": "Stone",
            "name_suffix": "",
            "institution": "California Hospital Association, Sacramento, California; University of California, Davis Public Health Sciences, Davis, California",
            "department": "None"
        },
        {
            "first_name": "Debby",
            "middle_name": "",
            "last_name": "Rogers",
            "name_suffix": "",
            "institution": "California Hospital Association, Sacramento, California",
            "department": "None"
        },
        {
            "first_name": "Sheree",
            "middle_name": "",
            "last_name": "Kruckenberg",
            "name_suffix": "",
            "institution": "California Hospital Association, Sacramento, California",
            "department": "None"
        },
        {
            "first_name": "Alexis",
            "middle_name": "",
            "last_name": "Lieser",
            "name_suffix": "",
            "institution": "California American College of Emergency Physicians, Sacramento, California",
            "department": "None"
        }
    ],
    "date_submitted": "2011-02-18T05:18:38Z",
    "date_accepted": "2011-02-18T05:18:38Z",
    "date_published": "2012-02-24T18:29:51Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/19175/galley/9496/download/"
        }
    ]
}