There are probably many who don’t recognize that we are in a depression. They are themselves doing well. The following is a story about the effects this depression is having around the country. People who have lost their homes or their jobs are under stress and, they come to find out, develop clinical depression, thoughts of suicide, and hopelessness.
What will anyone do about this?
Close the Emergency Rooms as discussed in this report?
Close Emergency Rooms? When ED’s are used by so many people suffering from the economic depression? Or close mental health services provided by state funding?
A WORSENING PROBLEM
The National Association of State Mental Health Program Directors (NASMHPD), an organization of state mental health directors, estimates that in the last three years states have cut $3.4 billion in mental health services, while an additional 400,000 people sought help at public mental health facilities.
In that same time frame, demand for community-based services climbed 56 percent, and demand for emergency room, state hospital and emergency psychiatric care climbed 18 percent, the organization said.
"This wasn't one round of cuts," says Ted Lutterman, director of research analysis at NASMHPD Research Institute. "It was three or four for many states, and multiple cuts during the year."
If the economy doesn't improve, next year could be worse because many community mental health agencies are cutting programs and using up reserve funds, says Linda Rosenberg, president of the National Council for Community Behavioral Healthcare.
"It's been horrible," she said. "Those that need it the most - the unemployed, those with tremendous family stress - have no insurance."
In the emergency room, this increased demand has meant doctors and social workers are spending hours and sometimes days trying to arrange care for psychiatric patients languishing in the emergency department, taking up beds that could be used for traditional types of trauma.
More than 70 percent of emergency department administrators said they have kept patients waiting in the emergency department for 24 hours, according to a 2010 survey of 600 hospital emergency department administrators by the Schumacher Group, which manages emergency departments across the country.
Ten percent said they had "boarded" patients for a week or more….
…This is the conventional wisdom: Priced out of health insurance, ever more Americans are crowding into emergency rooms because they can’t afford a trip to the doctor.
The study is based on national surveys conducted between 1996 and 2004. During that time, overall visits to the ER increased by 26% — but a disproportionate share of the growth came from those whose incomes put them at more than four times the poverty level, and who typically get their care at a doctor’s office. The percentage of uninsured ER patients remained flat, at roughly 15%.
The researchers did the study because the conventional wisdom didn’t seem to match the on-the-ground experience of ER docs. Instead, they saw a rise in ER traffic across the demographic spectrum, said Jonathan A. Showstack a study author based UCSF’s Institute for Health Policy Studies.
“Focusing the political debate and the health-care debate about the overuse and sometimes the ‘abuse’ of emergency departments by the poor and the uninsured is really missing the point,” he told the Health Blog. “It’s based on the wrong assumptions and an incorrect interpretation of what’s really going on.”
While expanding health insurance coverage may sound like a big enough issue to tackle, the findings of the study suggest that it wouldn’t do much to slow the influx of patients to emergency departments.
Instead, the the authors conclude, “increase in ED use may be attributable to lack of ready access to primary care and other structural problems in the health care system.” Trying to fix those will make the insurance issue look easy.