"It’s just the standard of care here," said Dave Hartford, the outgoing assistant commissioner of chemical and mental health services in the Minnesota Department of Human Services. "It would be hard to function without it."
The inventory of inpatient psychiatric beds is very tight, Mr. Hartford said, and without a registry system it would take hospital personnel hours to identify available beds on some days. "This is a way to save a lot of time and have options and actually serve patients," he said.
While the registry is well accepted today, Mr. Hartford said that it took some time for hospitals to make reporting bed availability part of their standard operating procedures. During the first year, the state hired staff to remind hospital personnel to report into the registry, he said.
Doris Fuller, executive director of the Treatment Advocacy Center, which produces reports on mental health services, said she favors registries as a way to get patients mental health treatment when they need it. But registries are just a tool, she said, and don’t create more capacity in the system.
"You can have a registry, but if there are not very many beds out there, where does that leave you? Ms. Fuller said. "The fundamental problem with boarding is that there simply aren’t enough beds for the number of people who are going to be in psychiatric crisis on any given day."
Dr. Leslie Zun, chairman of emergency medicine at Mount Sinai Hospital in Chicago and an expert on behavioral emergencies, said registries could provide some helpful information about bed availability, but that’s about all.
"I think it’s putting a [bandage] on a hemorrhage," he said.
Emergency physicians would be better served, Dr. Zun said, if they focused on lining up psychiatric services for boarded patients either through an onsite consultation or telepsychiatry. And ED physicians also need to look into alternative care sites like crisis stabilization units.
mschneider@frontlinemedcom.com
On Twitter @maryellenny