DEINSTITUTIONALIZATION AND ITS EFFECTS ON EMERGENCY MEDICINE

Emergency departments (EDs) across the country have been forced to accommodate an ever-expanding population of mental health patients. This study surveyed physicians and social workers in order to determine the most commonly treated mental illnesses in the ED, common frustrations in the care of mental health patients, limitations in the provision of treatment, and possible changes and improvements to the treatment system for the future. Attitudes toward the deinstitutionalization movement of the 1960s also were assessed, as this movement is hypothesized to have contributed to the current strain on EDs with respect to treating mental health issues. In this thesis, the deinstirutionalization movement and possible implications for mental health treatment in EDs are reviewed' In addition, questionnaires were administered to a sample of 6 ED doctors and 2 ED social workers-. Survey responses suggest that more resources, including availability of ED staff psychiatrists and dedicated facilities for mental health patients' would offer improvements to the current system. With careful evaluation of the ability of the ED to meet the needs of mental health patients, alternative resources for more effective and successful treatment strategies may be developed that offer a compromise between institutionalization and the revolving door of the ED.