A significant number of “avoidable” visits to US emergency departments (EDs) are for mental health and alcohol problems, as well as dental problems, which the ED is not fully equipped to treat. Using the National Hospital Ambulatory Medical Care Survey, the researchers analyzed data on 424 million visits made to US EDs between 2005 and 2011 by patients aged 18 to 64 years. The researchers “conservatively” defined “avoidable” ED visits as discharged ED visits that did not require any diagnostic tests, procedures, or medications. The authors of the study from the Department of Emergency Medicine, University of California, San Francisco note that: “Emergency physicians are trained to treat life- and limb-threatening emergencies, making it inefficient for patients with mental health, substance abuse, or dental disorders to be treated in this setting.” The study was published online August 31 in the International Journal for Quality in Health Care.
For practitioners, hospitals, and policymakers in Pennsylvania, reports like this and others raise the question: Where can these patients be best served in the community when urgent and emergency behavioral care services are not available in Emergency Departments? And also, how can communities and health care systems plan and practice whole person emergency care in an era of integrated and co-located physical and mental health care?