Tuesday, May 15, 2007

State Watch

Mental Health Patients Overwhelming New Jersey EDs, Officials Say

      A rising number of severely mentally ill New Jersey residents is "overwhelming" hospital emergency departments across the state, according to medical and mental health professionals, the Newark Star-Ledger reports. According to the New Jersey Hospital Association, as many as 25% of hospital beds in some EDs are occupied by psychiatric patients. Mental health professionals and state officials attribute the problem to an increasing population, efforts to downsize state hospitals, general hospitals that close voluntary psychiatric units to open more lucrative specialty units, such as those for cardiac care, and a lack of affordable housing for former state hospital patients.

Medical and psychiatric facilities in Morris County, N.J., recently issued a white paper to state officials requesting that they address the backlog of psychiatric patients, which has increased over the past three years. The white paper identified several systematic problems, including a lack of psychiatric beds, a failure to hold and treat clients in a safe and secure location, planned downsizing of available beds in the state mental hospital system, and challenges in moving patients with legal charges or violent criminal histories to appropriate state facilities. The white paper recommends that the state:

• Add more beds to mental health screening centers;
  
  
• Restructure the admission process to state hospitals;
  
  
• Develop a plan for when beds are not available;
  
  
• Improve communications between local hospitals and state facilities;
  
  
• Create intermediate-level beds for patients who have "decompensated" and require care for a few days to a few months;
  
  
• Require the state to assume or share costs sustained by hospitals when mental health patients wait in EDs for extended periods; and
  
  
• Re-evaluate the transfer of criminal and violent patients.
  

The state is trying to assess how many more short-term psychiatric beds are needed and where they should be located. The state also is trying to partner with hospitals to add the beds. In addition, the state is working to expand outpatient services that could prevent people from seeking ED care (Ragonese, Newark Star-Ledger, 5/13).