University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Emergency Medicine


Dr. Elyse Watkins


The purpose of this article is to examine the current management of boarded psychiatric patients in a hospital emergency department and identify areas to improve care and disposition. PubMed, Medline, and Google Scholar literature searches were conducted using the search terms psychiatric, emergency department, and boarding. Twenty-seven pertinent articles were retrieved and serve as the basis for this clinical review.

Hospital emergency departments frequently evaluate and treat psychiatric patients in acute crisis. These patients often spend greater than six hours in the emergency department and thus meet the criteria for “boarding.” During this stay, patients exhibiting symptoms of a psychiatric disorder often get treatment for their acute symptoms, but little or no treatment for their underlying condition. This discontinuity of mental health care can lead to frequent repeat visits and gradual decompensation of their baseline functionality, which in turn can lead to higher healthcare costs. The combination of an aging population and insurance reforms in healthcare that tend to ignore mental health will likely magnify the crisis. New approaches are being investigated to reduce psychiatric patient boarding times.

Keywords: Psychiatric, mental health, emergency medicine, boarding.


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