Survey: 8 in 10 ER Docs Say Mental Health System Is Not Working for Patients

Emergency Physicians, Nurses, Psychiatrists and Patient Advocates Unite to Change Treatment of Psychiatric Emergencies

Dec 15, 2015, 12:56 ET from American College of Emergency Physicians (ACEP)

WASHINGTON, Dec. 15, 2015 /PRNewswire-USNewswire/ -- More than 80 percent of emergency physicians say the mental health care systems in their regions are not working for patients, according to a new survey of nearly 1,500 emergency physicians.  To help address these challenges, more than 30 of the nation's top mental health and emergency medicine leaders are launching  the Coalition on Psychiatric Emergencies, also known as "COPE," aimed at improving patient care in emergency departments during psychiatric crisis.  

"More people are coming to emergency departments for help during psychiatric emergencies," said Michael Gerardi, MD, COPE Steering Committee Chair and immediate past president of the American College of Emergency Physicians.  "It's time we think about doing things differently. Through this unique collaboration, the Coalition on Psychiatric Emergencies will focus on developing a more unified treatment model and improving the treatment experience for both patients and health care providers.  We want to provide the best care for all our patients and reduce health care costs." 

The ACEP survey comes on the heels of two other national surveys that show the current model isn't working for either emergency staff or patients. A recent Emergency Nurses Association (ENA) study found a majority of emergency room nurses report a shortage of tailored education and training, which makes the care of patients with mental health issues more difficult. From a patient point of view, a recent National Alliance on Mental Illness (NAMI) survey found that 44 percent of patients were unhappy with their experience: 38 percent waited more than 7 hours to see a mental health professional, and in 21 percent of cases the wait was more than 10 hours.

Through the establishment of five working groups, COPE specifically aims to:

  • decrease waiting for inpatient psychiatric beds ("boarding") for psychiatric patients in emergency rooms;
  • ensure education and training for emergency health care providers who care for patients experiencing psychiatric emergencies;
  • ensure adequate funding and resources for treating psychiatric emergencies;
  • drive improved quality and safety of diagnosis and treatment for psychiatric emergencies;
  • advance the research around psychiatric emergencies;
  • develop a continuum of care to include prevention and aftercare; and
  • improve patient and health care provider experience during psychiatric emergencies.

This survey was conducted online from the membership of the American College of Emergency Medicine between July 1-31, 2015. The response rate was 6 percent and the margin of error of 2.5 percent.

COPE members include the American Academy of Emergency Medicine, the American Association for Emergency Psychiatry, the American College of Emergency Physicians, the American College of Osteopathic Emergency Physicians, the American Psychiatric Association, the American Psychiatric Nurses Association, the American Society for Healthcare Risk Management, the College of Psychiatric and Neurologic Pharmacists, the Depression and Bipolar Support Alliance, the Emergency Nurses Association , the Hospital Corporation of America, the National Alliance on Mental Illness, the National Council for Behavioral Health and is supported in part by Teva Pharmaceuticals.


  • Approximately 1 in 25 adults in the U.S.—13.6 million—experience a serious mental illness in any given year that substantially interferes with one or more major life activities[1].
  • According to the CDC, schizophrenia and other psychiatric disorders have the highest rate of ER visits of any chronic condition[2].
  • There is no universal protocol for the treatment of people experiencing a psychiatric emergency in the ER.

[1] Serious Mental Illness (SMI) Among Adults. (n.d.). Retrieved January 16, 2015, from  

[2] Kaltwasser J. 7 chronic conditions with the most emergency visits. HCP Live website. Published October 3, 2014.
Accessed November 19, 2014. 
Twitter:  @EmergencyDocs
Video link:

Logo -


SOURCE American College of Emergency Physicians (ACEP)