This problem isn’t just young people experiencing a mental health crisis, it involves the elderly awaiting placement in a geriatric psychiatry unit as well.

I work in a Hospital in NH and there have been multiple times where 30-50% of the ED beds are occupied as “psych holds” which puts an unbelievable stress on the ED. Usually it’s 2/3 young people and 1/3 elderly patients. Many times those elderly patients are unceremoniously dropped there by their families “because we can’t manage him/her anymore”. Other times they are sent in because of “altered mental status” from their home nursing facility. Frequently these patients are genuinely dangerous to be around or are a genuine danger to themselves due to progression of their cognitive impairment.

Often these patients have end stage dementia of one sort or another (god forbid Lewy body) and are unfixable. You can quell the symptoms sometimes with antipsychotic medications, but more often than not, you are just sedating them. Even if they move out of the ED and into the hospital for one reason or another, it just moves the problem to a new venue.

I had one patient spend close to 90 days on a general medical floor as their family just refused to take them back home. We ended up having to wait for public guardianship and long term medicaid to place them in a facility for the rest of their life.

This is a society-wide problem, and giving hospitals a month to come up with a plan is laughable. Unless they call out the Army to permanently fully staff a dozen new long term care psych units, this issue isn’t going to go anywhere.