Study: Psych Patients’ ER Waits In Boston Area Average 11 Hours

This just in from the American College of Emergency Physicians: a study led by Massachusetts General Hospital that offers some numbers to quantify the worsening problem of psychiatric patients waiting long hours in emergency rooms — significantly longer hours than other patients.

The study included five hospitals in the greater Boston area, two academic medical centers and three community hospitals; it does not name them explicitly.

WASHINGTON—Patients having psychiatric emergencies wait 11.5 hours in the emergency department, and those who are older, uninsured or intoxicated wait even longer, according to a study published online yesterday in Annals of Emergency Medicine (“Patient and Practice-Related Determinants of Emergency Department Length of Stay for Patients with Psychiatric Illness”). Overall, these patients wait approximately 42 percent longer in the ER than other emergency patients.

“Although we did not see differences between patients who were publicly and privately insured, patients without insurance spent four more hours in the ER than these other groups,” said lead study author Anthony Weiss, MD, MBA, of Massachusetts General Hospital in Boston, Mass. “These patients are waiting the longest for care, and shrinking resources are having a disproportionate effect on these very vulnerable people.”

Researchers analyzed records for 1,092 adults with psychiatric emergencies. Patients discharged home spent an average of 8.6 hours in the emergency department, while patients admitted to a psychiatric unit within the hospital stayed 11 hours. Patients transferred to an outside unit within the local health care system stayed 12.9 hours and those transferred to a facility outside the local health care system stayed 15 hours.

Younger patients waited less than older patients: in the 18 to 39-year-old group, the average length of stay was 10.7 hours, but patients older than 60 spent 12.6 hours in the emergency department. One-third of the patients tested positive for alcohol and these patients had average stays in the emergency department of 14.5 hours.

“Between 2000 and 2007, psychiatric visits to ERs grew by 231 percent,” said Dr. Weiss. “This increase in volume, when combined with fewer resources outside the ER, have led to a real crisis for this population. Long waits for care aren’t good for anyone but they are especially harmful to patients in psychiatric distress.”

Readers, what’s your experience? Longer? Shorter? Different?

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  • BoringCommenter

    After 24 hours they have to admit you to the hospital, whether they have a psych bed or not, which at least gets you out of the ER room. (the clock doesn’t start until you actually get into the ER room, though)    Last time my wife was at Lahey for 36 hours, before they found space in a facility 50 miles away.  Understandably, they also overmedicate, compared to proper mental hospitals.  I would love to see the numbers broken down by ER room.  This sort of information would be extremely helpful, both for patients, and also to pressure facilities to improve.

  • aj

    having been admitted to a few different inpatient psych units in the past 5 years, 11 hours seems short.  when i have been admitted the hospital where i was seen in the psych ER, it always took at least 12 hours.  when being transferred it usually took 14 – 16 hours and it once took 29 hours to be seen at a community hospital ER and then sent to a psych ER and then to a locked ward.  

    Friends who have been admitted for addictions seem to have an easier time of it–spending no more than 6 hours in the ER.

  • Kim Kushner

    I have seen people spend DAYS, not hours, waiting for pyschiatric care in emergency rooms. Remember this is an average and many are waiting even longer.