142nd APHA Annual Meeting and Exposition

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Emergency Room Enhancement: Improving Access to Behavioral Health Care

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:30 PM - 3:50 PM

Rita Adkins, MPA , Center for Research and Evaluation, Missouri Institute of Mental Health, St. Louis, MO
Mary Dugan, PhD , Missouri Institute of Mental Health, St. Louis, MO
  
Audio (mp3) recording Recorded Presentation (mp4)
Background: Results from the 2012 National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration report that almost 44 million adults aged 18 or older, or (20% of the population) have a diagnosis of a behavioral health disorder. Many are reluctant to seek needed assistance, citing the cost, stigma and not knowing where to seek help as the main reasons, and often end up in the Emergency Room (ER) for care. The 2011 Nationwide Emergency Department Sample (NEDS) reported that 12.6 million ER visits, almost 10% of all patients seen, involved a primary diagnosis of a behavioral health condition or substance abuse disorder.

Similar to national trends, health care professionals across the state of Missouri have witnessed an increase in patients seeking help for behavioral disorders and substance use conditions. Oftentimes these individuals seek care in hospital emergency rooms where they are stabilized and released without being referred for the needed follow-up care, resulting in a revolving door leading back to the ER.

Missouri has responded to this trend by developing a Mental Health System sponsored Emergency Room Enhancement (ERE) Initiative. The intent of this initiative was to increase access to behavioral health care for citizens who need treatment for behavioral health conditions or substance use disorders. The presentation will describe the design and findings of the initiative and show how  the coordination of care was improved between hospitals, community mental health centers and substance abuse providers.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate potential linkages between project activities and improved outcomes in emergency room utilization, treatment program utilization, housing, employment and criminal justice involvement. Describe the procedures for creating a collaboration to provide wrap around care for individuals with behavioral health disorders that frequently end up in the ER for needed care. Discuss barriers to implementation and program successes. Describe findings from participant focus groups, to guide future collaborative endeavors.

Keyword(s): Mental Health Treatment &Care, Emergency Medical Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Adkins has over 18 years of experience in project management. She is currently the PI for the evaluation of the ER Enhancement project in Missouri, designed to decrease ER visits by increasing access to CMHCs for people seeking help for behavioral health conditions, and was the Project Manager for the Consumer-Operated Services Program Coordinating Center, evaluating existing consumer-run peer support programs for adults with SMI when offered as an adjunct to traditional MH services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4349.0: Emergency Departments and Mental Health: Utilization, Outcomes and Service Design