A mental health crisis can happen anytime. When it does…
The emergency room tends to be the first place people visit for psychiatric help. Mental health conditions account for 12.3% of emergency department visits made by U.S. adults every year.
That’s a lot of ER visits.
But most people don’t know what happens during a psychiatric emergency room visit. Not knowing the process creates fear. It makes what should be an already-stressful situation even worse.
Don’t worry.
There’s no reason to feel that way. By knowing what to expect during a mental health ER visit, you can ease the fear and tension around the situation. Here’s what you need to know about psychiatric consultation services in the emergency room:
What you’ll learn:
- What Happens When You Reach at the ER
- How Psychiatric Consultation Services Work
- What a Mental Health Assessment Looks Like
- How Long the Whole Process Takes
- What Happens After Your ER Visit
What Happens When You Arrive at the ER
Entering the ER during a mental health crisis isn’t ideal. But thankfully there’s a set process every hospital follows when a patient arrives.
Step one is triage. Nurses will examine the patient and determine priority level. Triage is common with physical emergencies. But for mental health crises, nurses are checking for things like suicide attempts, panic attacks, psychosis, and self-harm.
After triage, patients are escorted to a safe area of the ER. More hospitals are designating specific psychiatric areas in their emergency rooms. This keeps mental health patients separated from the rest of the ER. Creating a more calming environment.
Pro tip: Bring any medical information you have. This includes medications, previous diagnoses, and emergency contacts. Anything you can give doctors will speed up the process.
How Psychiatric Consultation Services Work
Okay, now things are getting somewhere.
Once patients are cleared at the ER, psychiatric consultation services take over. This is when a psychiatrist, psychologist, or licensed mental health professional will be requested to evaluate the patient.
The role of the psychiatric consultation services is to determine a plan of action. Whether that’s medication, involuntary commitment, or release.
Every hospital operates psychiatric consultation services differently. Larger hospitals typically have on-site psychiatric teams that work in the ER at all times. Smaller hospitals, and most rural hospitals, utilize telepsychiatry services to virtually connect their patients to psychiatric professionals.
Regardless of how your hospital operates, the psychiatric consultant will meet with the patient. They review their findings with the care team. And recommendations are made for treatment.
Here’s what they’ll evaluate:
- Current symptoms
- Severity of symptoms
- Past medical history and psychiatric history
- Current medications
- Risk of self-harm or harm to others
- Recommendations for treatment and care after evaluation
Once the psychiatric consultation gives their recommendation, the patient will receive a treatment plan. That’s why this step is so important. The psychiatric consultant helps determine what happens next for patients.
What a Mental Health Assessment Looks Like
Contrary to popular belief, mental health assessments aren’t scary.
Mental health assessments are done by medical professionals to better understand your needs. They’re completed by asking you a series of questions about your current state of mind. Questions like…
How are you feeling? What led to this visit? Have you been harming yourself? Do you have a history of mental illness? Are you currently on any medications?
Remember…
The more honest you can be with the professional conducting the assessment, the better they can help you. Mental health assessments aren’t effective if you leave out important information.
Assessments typically include a full physical and blood work to rule out any medical conditions that could be impacting your mental health.
How Long Does It Take?
The million-dollar question.
It varies from hospital to hospital, but mental health patients waiting in the ER can experience long wait times. One study published in PMC found psychiatric patients experience average boarding times in the emergency department ranging from 6.8 hours to 34 hours.
That is dramatically longer wait times than other ER patients.
While there are many reasons psychiatric patients wait longer in emergency departments. A few reasons include:
- A shortage of psychiatric beds
- Many hospitals don’t have psychiatric staff on-site 24/7
- Mental health assessments take longer than standard medical assessments
- Some hospitals must transfer patients to other facilities for psychiatric care
If you or a loved one are seeking mental health care in the ER, be prepared to wait. Bring a phone charger, book, water, or anything that could provide comfort during a long wait. And if possible, change into comfortable clothes.
What Happens After Your ER Visit
Your journey doesn’t end with the ER visit.
If your condition is stabilized after the mental health assessment, there are a few options for you. The inpatient treatment team will decide what they believe is next steps for your care.
Here are your options:
- Inpatient admission: Patients are admitted to the psychiatric unit if they pose a danger to themselves or others.
- Outpatient referral: If the patient safely leaves the ER, they will likely receive a referral to an outpatient mental health provider.
- Crisis stabilisation: Some hospitals offer crisis stabilization services that last up to a few days.
- Safety planning: Patients are provided with a safety plan upon discharge. And care teams go over the plan with patients prior to release.
One thing to note…
After-care is essential. Patients who don’t utilize after-care services after a psychiatric emergency department visit are six times more likely to go back to the emergency room within two months.
That’s staggering. Not following up with the care team can be just as detrimental as not going at all.
Pulling It All Together
Successful to the ER for a mental health crisis is overwhelming. But once you know what to expect, it doesn’t seem so bad. Here’s what you can expect during a mental health emergency room visit:
- When you arrive to the ER, nurses will perform triage to determine the severity of your condition.
- Psychiatric consultation services will take over and provide a treatment plan for your care.
- You’ll undergo a mental health assessment to determine your current state of mind.
- Wait times in the ER can be long. Be sure to bring things to keep you occupied.
- After your ER visit, you’ll meet with the inpatient treatment team to determine next steps for your care.
Remember…
Seeking mental health care at the ER is the right step to take. You are giving yourself access to psychiatric consultation services and medical professionals who can help get you the right care. Don’t be afraid to reach out for help.
Emergency rooms are just a starting point for your mental health journey.
