Mental Health-Related Emergency Room Visits

Mental Health-Related Emergency Room Visits

“There’s a wide variety of mental health issues that arise in the emergency room,” said Melissa Rapp, Boone Health Social Worker. “It is such an integral part of our lives and when you have good mental health, you tend to take it for granted.”

Reasons that people need emergency room care when having a mental-health crisis can include patients who are having thoughts of harming themselves or others, patients who are struggling to take care of themselves, severe depression, anxiety, and thought disorders such as Schizophrenia or Bipolar Disorder. There are also elderly patients who might be experiencing dementia, and patients who are struggling with addiction and possibly a whole host of other social issues that may be a symptom of mental health problems. Substance abuse and addiction presents in all ages and demographics.

The emergency department’s social workers consult patients who come with mental health issues who are on a spectrum – mental health conditions can vary in severity and are not all equal. “Some are in more serious situations than others,” Melissa said.

“Often times, what comes with mental health issues are physical health issues, so our emergency department may also have to assist in addressing those physical conditions as well,” Melissa said.

Physical health conditions can include diabetes, dental infections, cardiovascular issues or even substance withdrawal. “It’s a very wide range of issues that a person could present with to our emergency department. It may be that they have those conditions because they are unable to attend to their own self-care or what they are doing to themselves may be damaging to them physically,” Melissa said.

Patients who have mental health issues who end up unhoused will come to the emergency room. They may not be eating regularly, may not be getting adequate sleep, and struggle with getting medications or even being able to connect with a provider. The social workers in the emergency department can help with those things before the patient leaves. The social workers also assist patients getting connected with outpatient resources in the community or help get them referred if they require inpatient hospitalization.

“It’s common place for us to call all over the state of Missouri looking for facilities that might have beds open for psychiatric inpatient,” Melissa said. “ The resources in the state of Missouri are really limited for that. It can be quite time-consuming to locate and facilitate the transfer of a patient to a psychiatric unit.”

Depending on the needs of the patient, there are several options in mid-Missouri for substance use as well as for mental illness. Services like therapy and medication management are offered. Burrell Behavioral Health, Compass Health and New Horizons are examples of where they might refer a patient who is limited financially and can’t go through a private provider.

“We provide information on mental health and substance abuse daily in the emergency department,” Melissa said. Boone Health’s Emergency Department has three social workers:

Melissa Rapp, Kim Oliver and Trish Gonzales. Kim and Melissa are Licensed Clinical Social Workers (LCSW) and Trish is a Licensed Master Social Worker (LMSW) with over 400 hours of supervised training in their field.

“It’s a profession even more rigid than others,” Kim said. “We have a code of ethics that guides our practice. This document outlines core values, ethical principles and standards for practice. It helps us navigate ethical dilemmas and make sound decisions in our practice.”

“Mental health is an area that, as a society, we have really neglected. Period,” Melissa said. “The system is far from perfect. It’s my hope that someday, our society will regard mental health’s importance equal to other physical health conditions.”

By Erin Wegner