Abstract
Since the peak of state-run mental health hospitals in 1955, which reached 344 beds per 100,000 population, there has been a steady decline. In 2014, the number was 11.7, with 5.4 beds filled with forensic patients [1]. As these public hospitals have declined in beds, patients have moved into the community. At first, this deinstitutionalization was thought to be preferable, but this change brought with it a rise in the mentally ill found in jails, prisons, or warehoused in emergency departments (ED) awaiting psychiatric hospitalization.
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References
Beyond beds: the vital role of a Full Continuum of Psychiatric Care. National Association of State Mental Health Program Directors. 2017 Oct. Available at http://www.treatmentadvocacycenter.org/storage/documents/beyond-beds.pdf. Accessed on 25 Mar 2020.
APA official actions: position statement on emergency boarding of patients with acute mental illness. 2016 July. Available at: https://www.psychiatry.org/File%20Library/About-APA/Organization-Documents-Policies/Policies/Position-2016-Emergency-Department-Boarding-of-Patients-with-Acute-Mental-Illness.pdf, Accessed on 25 Mar 2020.
Nordstrom K, Berlin JS, Nash SS, Shah SB, et al. Boarding of mentally ill patients in emergency departments: American Psychiatric Association Resource Document. West J Emerg Med. 2019;20(5):690–5.
Manual A, Longer AMN, Seal UG. The patient flow standard and the 4-hour recommendation. Jt Comm Perspect. 2013;33(6):1–4.
Corbett B, Nordstrom K, Vilke G, Wilson MP. Psychiatric emergencies for clinicians: Emergency department diagnosis and management of steroid psychosis. J Emerg Med. 2016;51(5):557–60.
Lasoff D, Vilke G, Nordstrom K, Wilson MP. Psychiatric emergencies for clinicians: Detection and management of Anti-N-Methyl-D-Aspartate receptor encephalitis. J Emerg Med. 2016;51(5):561–3.
Nordstrom K, Vilke GM, Wilson MP. Psychiatric emergencies for clinicians: The ED management of serotonin syndrome. J Emerg Med. 2016;50(1):89–91.
Sharp CS, Wilson MP, Nordstrom K. Psychiatric emergencies for clinicians: The ED management of thyroid storm. J Emerg Med. 2016;51(2):155–8.
Wilson MP, Vilke GM, Hayden SR, Nordstrom K. Psychiatric emergencies for clinicians: the ED management of neuroleptic malignant syndrome. J Emerg Med. 2016;51(1):66–9.
Hirschfeld RM, Baker JD, Wozniak P, et al. The safety and early efficacy of oral-loaded divalproex versus standard-titration divalproex, lithium, olanzapine, and placebo in the treatment of acute mania associated with bipolar disorder. J Clin Psychiatry. 2003;64(7):841–6.
Tamayo JM, Zarate CA, Vieta E, et al. Level of response and safety of pharmacological monotherapy in the treatment of acute bipolar I disorder phases: a systematic review and meta-analysis. Int J Neuropsychopharmacol. 2010;13(6):813–32.
Warden D, Madhukar H, Trivedi MD, et al. Early adverse events and attrition in SSRI treatment: a suicide assessment methodology study. J Clin Psychopharmacol. 2010;30(3):259–66.
Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356(17):1711–22.
Lewis J, Winokur G. The induction of mania: a natural history study with controls. Arch Gen Psychiatry. 1982;39(3):303–6.
Richmond JS, Berlin JS, Fishkind AB, et al. Verbal de-escalation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA De-Escalation Workgroup. West J Emerg Med. 2012;13(1):17–25.
Wilson MP, Moutier C, Wolf L, Nordstrom K, et al. Emergency department recommendations for suicide prevention in adults: the ICAR2E mnemonic and a systematic review of the literature. Am J Emerg Med. 2019;37:2246; [Epub ahead of print]. https://doi.org/10.1016/j.ajem.2019.06.031.
Leon AC, Solomon DA, Li C, et al. Antidepressants and risks of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatry. 2011;72(5):580–6.
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Nordstrom, K. (2021). Boarding of Psychiatric Patients in the Emergency Department. In: Zun, L.S., Nordstrom, K., Wilson, M.P. (eds) Behavioral Emergencies for Healthcare Providers. Springer, Cham. https://doi.org/10.1007/978-3-030-52520-0_25
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DOI: https://doi.org/10.1007/978-3-030-52520-0_25
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