WestJEM. 2019 July

At the core of the problem is the fact that in recent years more and more patients find themselves seeking care for psychiatric illness in EDs. The annual number of all-cause ED visits has continued to increase with 6–10% of patients presenting for psychiatric illness and related concerns. This is considered a “small but increasing subset” of the ED visit population. Psychiatric visits weigh heavily on the ED system. They have been found to occupy more time (42% longer than non-psychiatric visits), result in increased inpatient admission (24% vs 12%) and transfer (16% vs 1%), and occupy a higher percentage of self-pay or charity care (22% vs 16%) compared to non-psychiatric visits. Furthermore, the duration of time spent in the ED is especially long for patients who require transfer to a different facility or who carry a diagnosis of significant mental illness or substance use disorder.