- npr.org/2011/04/13/135351760/mentally-ill-languish-in-hospital-emergency-rooms
- kaiserhealthnews.org/stories/2011/april/13/er-psychiatric-patients.aspx?
List date(s) this work was published or aired.
4/13/2011
Provide a brief synopsis of the story or stories, including any significant findings.
With states reducing the number of psychiatric beds, mentally ill patients are often boarded in hospital emergency rooms for several days, sometimes longer. At most, they get medicine but little or no counseling, and the environment is often harsh. The experience can be devastating for mentally ill patients and stressful for providers and hospitals. But as states have looked for ways to cut mental health spending during the recession, at the same time that many Americans have lost their private insurance, the problem has only gotten worse. We personalize the problem by talking with a patient while he was stuck in the emergency room, waiting for a psychiatric bed.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
-Records including 990s requested through Miriam and Memorial Hospital -Erik’s medical records obtained through the RI Mental Health Advocate -state-by-state data on cuts in psych beds and mental health funding from NASMHPD -ACEP data on total mental health visits to ERs -data from the state of Rhode Island (requested several times before obtained) to track their problems placing mentally ill in psych beds and whether attempts to address the problem were working -many searches of medical journals for articles on ER boarding -professional surveys of ER doctors -legal language of Medicaid rules excluding psychiatric institution reimbursement
Explain types of human sources used.
-The biggest challenge was finding a patient who was in the midst of a crisis and willing to be interviewed. With the help of the Rhode Island Mental Health Advocate, Jenny found Erik, a young man with schizoaffective disorder for whom no bed was available in the entire state. She interviewed him several times on the cell phone from an ER while he waited for a psychiatric bed to become available. While Memorial Hospital in Providence, R.I., where Erik was boarded, would not allow a reporter to visit, she had the opportunity to see a similar situation first-hand at nearby Miriam Hospital, where several patients were also waiting for psychiatric care. -Other families who had experienced ER boarding in several states -Emergency room doctors at Rhode Island hospitals -Several Rhode Island officials, including the Mental Health Advocate and the Director of the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals -Mental health officials from Maryland and Wisconsin -Mental health advocates from state and national groups, including NAMI and Bazelon -Heads of industry groups representing emergency room providers and Departments, including Dr. Kit Schumacher, ACEP and AHA -Experts from research institutes and nonprofits, including National Association of State Mental Health Program Directors, the National Council for Community Behavioral Healthcare and the National Association of County Behavioral Health and Developmental Disability Directors
Results:
Erik was given a bed in a state hospital soon after our interview, though we can’t say for sure that our inquiries were the reason why. The story also lit up the blogosphere and inspired other journalists across the country to report on the worsening trend.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
None.
Advice to other journalists planning a similar story or project.
We think the success of this story depended upon talking with Erik while he was actually in the emergency room and urge anyone considering a similar project to work with patient advocate groups and wait for the right person and situation to best illustrate the story.