Psychiatric patients have been boarded as long as Dr. Michael Bernstein has been practicing medicine.
“But it used to be a rare event,” said Bernstein, the medical director of PeaceHealth Southwest Medical Center’s Behavioral Health program, who has two decades of experience.
The state’s top court recently banned the practice of holding patients who have been involuntarily committed because they pose harm to themselves or others in emergency rooms without treatment. The state has until Dec. 26 to end psychiatric boarding.
Boarding has “become more and more common,” Bernstein said. “I think it’s been gradual. We’ve sort of been complacent about its occurrence and it’s become more routine. Whenever it happens, we don’t like it, but it’s normal procedure. But that doesn’t make it right.”
The court’s order means the Washington Legislature’s budget writers will now be tasked with finding money to fulfill two court orders. In the so-called McCleary case, the court ruled the state was not adequately funding the state’s public schools and recently held lawmakers in contempt.
“The courts have told us in McCleary our kids’ constitutional rights are being violated,” said Rep. Laurie Jinkins, D-Tacoma, who has pushed for more mental health funding. “Likewise, we have these people being boarded in hospitals and their rights aren’t be addressed.”
The governor recently allocated $30 million to help identify more therapeutic beds for those who pose potential harm to themselves or others. But those millions aren’t expected to help Southwest Washington. As local officials seek alternatives, they hope lawmakers add money for mental health to the top of their to-do list as they craft the budget this upcoming legislative session.
Angela Graves, the clinical manager of the emergency department at PeaceHealth Southwest Medical Center, said patients of all age ranges, from pediatrics to elderly, have been boarded at her facility.
“The emergency room is equipped to help in psychiatric emergencies, but we’re not equipped to do therapy,” Graves said.
The patients boarded at PeaceHealth do receive visits from therapists and medication, but the situation is not ideal.
“When (the patients) are sitting here, waiting for a bed, there’s no healing. They are just waiting to get things started. The rooms are, I wouldn’t even say sparsely, they aren’t decorated … There’s no TV, no music, no windows, quite frequently there is someone next door screaming. It’s not a long-term environment you want to be in.”
Hospital officials estimate 105 to 110 patients were involuntarily committed and stayed an average of one to three days in the emergency room from January 2013 to January 2014.
Kathy Spears, with the Behavioral Health and Service Integration Administration, said the state agency is in the preliminary stages of looking where beds are available and where more could be purchased.
“We’ll definitely be asking for money in the budget to handle the single-bed certification to purchase mental health services,” Spears said.
Bernstein said he hopes lawmakers see the boarding situation as a symptom of the larger problem of ignoring mental health care.
“There has been a systematic defunding of mental health care for decades,” he said.
