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Volunteers Helping to Ease Stress in the Emergency Room

     

An estimated one in eight emergency room visits involves a mental health and/or substance use condition, according to the Agency for Healthcare Research and Quality. All too often when people go to emergency rooms with psychiatric conditions they end up waiting much longer than people with other health concerns.

People needing mental health care wait on average almost two hours longer in the ER than people needing general medical care. More than twice as many psychiatric patients as general medical patients waited in the ER for more than six hours. The combination of increasing use of emergency rooms for psychiatric concerns, limited availability of psychiatric beds and shortage of mental health professionals in some areas have contributed to often very long wait-times in emergency rooms.

The long waits can be extremely challenging. The environment in emergency rooms are generally very busy, noisy, brightly lit—conditions that make a difficult situation even more so for a person experiencing a mental health crisis. Many ERs are making accommodations, such as quieter rooms with lower lighting or separate areas for people with psychiatric concerns.

emergency.jpgThe emergency department at Columbia University Comprehensive Psychiatric Emergency Program has developed a program involving volunteers to help. Most patients stay in the emergency room 16 to 24 hours, although they may stay up to 72 hours. Care typically involves psychiatric assessment, social work intervention, medication, nursing care and planning for next steps.

The new program uses trained volunteers to provide various support services for patients and their family/friends. Volunteers are trained in basic psychiatric diagnoses, supportive techniques, verbal de-escalation, group facilitation and principles of trauma-informed care.

An initial role of the volunteers is to orient patients to the ER environment and to make sure their basic needs are met. They spend time talking and actively listening to patients. They engage individuals in relaxation and recreational activities such as poetry writing, coloring, clay sculpting, puzzles and board games, music and breathing exercises. The volunteers created a comfort cart to easily bring a variety of stress reduction and entertainment items to patients.

The volunteers also conduct wellness groups on such topics as calming techniques, sleep hygiene, mediation management and mindfulness. Patients family/friends are invited to participate as appropriate. The volunteers help improve overall safety by reporting to staff any concerning behaviors, worsening distress or self-harm/suicidal thoughts. Volunteers meet monthly as a group to discuss their experiences and to share best practices. The program has received positive evaluations from patients, from volunteers and from staff.

Easing the distress and stress and improving the emergency room experience may also help to improve outcomes for those enduring long waits.

Reference

Campbell, K, Samuel, D, Dragatsi, D. Frontline Reports: Treating Patient Well-Being in a Psychiatric Emergency Room. Psychiatric Services. Published online Aug. 28, 2018.

     

AnxietyPatients and FamiliesSchizophrenia

 

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