People experiencing an acute overdose, substance withdrawal symptoms or other life-threatening conditions usually are rushed to emergency rooms (ERs). In Los Angeles County, according to the present law, paramedics need to take patients with drug or alcohol-related conditions or psychiatric symptoms to an ER where they may have to wait for hours or days for a bed.
This norm can put a strain on the resources of ERs and may delay the treatment needed by such patients. With an eye on improving the situation, Supervisor Janice Hahn of the Los Angeles County Board of Supervisors recently introduced a motion to change the law requiring emergency medical service paramedics to take people who are intoxicated or have a mental health crisis. Instead, the proposed legislation would allow such people to be taken to “sobering centers or acute mental health facilities.” The Board voted unanimously to support the legislation.
“The bottom line is that if people like you and I can take an individual to a sobering center or mental health urgent care center, why can’t a highly trained medical professional do the same?” Hahn asked. One reason might be a lack of space.
More sobering centers needed
There are many supporters of the idea that keeping mental health patients in ER’s is inappropriate and costly. But to bring about the change, the proposed facilities must first exist to take in the patients. As of 2013, there were fewer than 100 beds available at the 11 “sobering centers” across the U.S. A study published in 2016 suggested substantial shortfalls in the psychiatric hospital system. For instance, it said that North Carolina needed to increase the bed capacity by 165 percent to bring the average wait time for a bed below 24 hours. At the national level, about 11 beds existed per 100,000 people but the estimated number should be 40 to 60 per 100,000 people.
To get an idea about the bed capacity required to support this legislation, it is important to know about the ER visits. According to the Centers for Disease Control and Prevention (CDC), an average of 354 per 100,000 people visited ERs for drug overdose each year between 2008 and 2011, when the opioid epidemic was not as bad as it is now. ER visits for alcohol-related diagnoses were estimated to be over 900 per 100,000 for males and about 40 per 100,000 for females. Thus, drug and alcohol-related problems would require 1294 beds per 100,000 people. Then will need another set of beds for psychiatric patients.
Looking at the growing addiction and overdose problem, the Board’s vote is important because it addresses the need for more specialized care for behavioral health care patients and will help ease the burden on ER’s. However, implementation of the proposed legislation will first require funding and construction of said facilities in sufficient quantities.
The Sovereign Health of California is striving to meet the mental health needs of the Americans. As a leader in the treatment for mental illness, substance use disorders and co-occurring illnesses, we combine the most accurate and effective approaches to diagnostic assessment and treatment, providing optimal long-term outcomes. Comprehensive treatment includes novel, conventional and holistic therapies. Our care plans are tailored according to the needs of the individual. Our ongoing continuing care program provides the support that patients need to recover and remain free from addiction. To find out more about specialized programs at Sovereign Health, call us at our 24/7 helpline number.
About the author
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. Sovereign Health is a professional information resource and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.