Extended mental health care in the ED: What’s a facility to do?

Unless he or she needs medical care, a patient with a mental health issue can only be involuntarily held in a hospital emergency department for 72 hours. At the end of that interval, the patient must either be admitted to a psychiatric unit or discharged. How can a hospital respond when a patient needs to be admitted, but there are no beds available?    

Because there are too few psychiatric unit beds in Ohio to care for and house patients who need such services, it is not uncommon for an emergency department to be unable to locate a psychiatric bed for a patient who needs one within the 72-hour time limit. The law currently puts hospitals in a very difficult position when they find themselves in this situation. One option is to discharge the patient. However, not only does this create the opportunity for the patient to harm someone, but it exposes the hospital to liability for that harm. Another option is to continue to hold the patient beyond 72 hours, preventing the patient from causing harm but exposing the hospital to claims of false imprisonment by the patient. 

Even as new psychiatric units come online around the state, until mental health resources more closely match the needs of our communities or until there is a change in the law that provides better options, hospitals must evaluate the facts of each situation from a risk management and patient care perspective and decide between the currently available options.