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I am a local Emergency doctor.  We see hundreds of mental health crisis patients per year, arriving by ambulance, police and helpless family members.  They stay in the ER for days, awaiting psychiatric bed assignment.  There are woefully few outpt psych services for people who do not meet the bar for involuntary hold.  

Those who do meet involun hold criteria are often released before a psych bed assignment is made, because we medicate them while in the ER to "keep the peace" (to not have to use physical restraints).  They then do not get outpt followup, do not continue to take meds, and then are back.

Also, many homeless people use the ER for shelter, food and medication, as they are "kicked"out of the shelters in the early morning.  They then develop suicide ideation and then appear in the ER.

posted 3 years, 1 month ago
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