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Access to Mental Health Services Strained as Benefits Expand

Jacqueline Fellows, for HealthLeaders Media, February 27, 2014

On any given day, there are scores of psychiatric patients waiting in emergency departments for an inpatient bed. The strain on the healthcare system will worsen this year, as federal rules expanding behavioral health benefits come into play.

Federal rules for 2014 give Americans more access to behavioral health coverage, but providers' ability to meet what may be a pent up demand for services is questionable. That's because hospitals and health systems are already struggling to meet the needs of a growing number of patients with mental health diagnoses.

There is no shortage of examples that show the limits of mental healthcare in this country. On any given day, there are scores of psychiatric patients waiting in emergency departments for an inpatient bed. Known as boarding, the amount of time a psych patient waits in an ED varies across the country. In California, the average is 10 hours. In central Ohio, it's 19.

EDs are a common landing ground for psychiatric patients because over the last decade there has been a reduction of inpatient beds, psychiatrists, and state funding for mental health services.

California is one of the many states where the issue of psychiatric patients waiting in EDs is acute. Out of the state's 58 counties, says Sheree Kruckenberg, VP of behavioral services for the California Hospital Association (CHA), 26 have no psychiatric treatment facilities.

"Most counties have just washed their hands and are leaving it up to the hospital EDs to manage this population," says Kruckenberg.

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1 comments on "Access to Mental Health Services Strained as Benefits Expand"


Sam Kaplan (2/28/2014 at 9:27 AM)
Mental Health Parity did not become a reality until preexisting conditions were covered under ACA. It will take a number of years for supply (psychiatric facilities and psychiatrists) to catch up with the increasing demand for mental health services. It may well be reasonable to adopt short-term strategies using urgent care as the article suggests, but long-term adjustments to the market for mental health services will provide a more stable solution.