Emergency rooms are often associated with physical problems, but on-demand mental health services can help ERs address mental health problems as well. In recent years, there has been a significant increase in the number of individuals seeking help for mental health concerns, but this demand for mental health support places strain on other patients and the emergency department staff. For this reason, improving care of psychiatric patients in the emergency department remains a growing priority for hospitals nationwide.
This article explores the challenges faced by patients and providers, what mental health conditions are commonly seen in the ER and could be treated via telepsychiatry, and how ER crisis care services help emergency departments use resources more efficiently, resulting in a higher quality of care.
If you are looking to streamline psychiatric care in your emergency department (ED), contact us. We can help relieve some burden from your staff.
Most Common Mental Health Complaints Treated in the ER
Emergency departments are often the first point of care for patients experiencing a mental health crisis. From anxiety and depression to psychosis and suicidal ideation, the demand for mental health services in the ER can overwhelm staff and create bottlenecks in patient care.
Reports show that in the United States, 12.5% of 150 million annual emergency department visits are primarily related to a mental health or substance use disorder.
Many of these cases don’t require admission or hands-on intervention and can be effectively managed by a licensed online psychiatrist or telemental health professional. By triaging appropriate patients to on-demand psychiatric care, hospitals can reduce wait times, ease staff burden, and ensure critical cases receive the immediate attention they need.
1. Anxiety Disorders
Anxiety disorders, including generalized anxiety disorder and panic disorder, are among the most prevalent mental health conditions seen in the ER. These disorders are characterized by excessive worry, often accompanied by physical symptoms like rapid heartbeat, shortness of breath, and dizziness. ER visits for anxiety disorders may be triggered by panic attacks, severe phobic reactions, or an overwhelming sense of dread.
2. Mood Disorders
Mood disorders, such as major depressive disorder and bipolar disorder, also frequently lead individuals to seek emergency care. These disorders can cause depression so severe that individuals may experience suicidal thoughts or engage in self-harming behaviors. Bipolar disorder, characterized by alternating periods of mania and depression, can also lead to impulsive actions and risky behaviors that necessitate emergency intervention.
3. Psychotic Disorders
Psychotic disorders, such as schizophrenia and schizoaffective disorder, can manifest with hallucinations, delusions, and disorganized thinking. These symptoms can be distressing and disruptive, leading individuals to seek help in the ER. Emergency care in these cases often involves medication to manage acute symptoms and ensure the safety of the individual and others.
4. Trauma-Related Disorders
Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) are trauma-related disorders that can develop after experiencing or witnessing a traumatic event. These disorders can cause flashbacks, nightmares, hypervigilance, and emotional numbness. Individuals with PTSD or ASD may seek on demand mental health services during periods of intense distress, or when triggered by reminders of the trauma.
How Telepsychiatry Is Improving the Care of Psychiatric Patients in the ER
On-demand mental health services are transforming emergency departments by providing timely, expert psychiatric care without overburdening in-house staff. Telepsychiatry enables hospitals to stabilize patients faster, reduce bottlenecks, and allocate resources more efficiently—all while enhancing the overall patient experience.
Operational and Financial Benefits for EDs
Hospitals pay only for the hours they need, making telepsychiatry a more cost-effective alternative to full-time, in-person mental health staffing. This flexibility allows emergency departments to scale psychiatric coverage up or down depending on patient volume, without compromising on quality of care. By integrating on-demand mental health services, hospitals can improve efficiency, reduce unnecessary admissions, and optimize staff resources.
- Shorter Length of Stay: Rapid psychiatric evaluations reduce patient boarding and free up ER beds faster.
- Cost-Effective Care: Virtual consults cost less per patient than traditional in-person psychiatry.
- Fewer Inpatient Admissions: Many patients can be discharged or referred to outpatient care after a virtual assessment.
- Reduced Liability: Quicker evaluations lower the risk of adverse events and legal exposure.
- Improved Throughput & Satisfaction: More efficient care improves ED flow and raises HCAHPS scores.
- Direct Access to Specialists: Patients are evaluated by licensed psychiatrists, rather than general ER doctors, ensuring more accurate diagnoses and appropriate care plans.
Safety & Compliance Benefits for Health Organizations
Telepsychiatry isn’t just convenient, confidential, and compliant. Virtual mental health providers follow the same evidence-based protocols as in-person psychiatrists and adhere to strict HIPAA and telemedicine standards. By offering immediate access to care, hospitals can reduce safety risks and close gaps in behavioral health staffing, especially during nights, weekends, and peak hours.
- Clinical Best Practices: Telepsychiatrists follow APA guidelines and evidence-based protocols for acute mental health care.
- Regulatory Compliance: Services are fully HIPAA-compliant and meet national telemedicine standards.
- Enhanced Patient Safety: Swift intervention reduces the risk of escalation, violence, or elopement.
- Always-On Coverage: 24/7 access to licensed professionals helps close behavioral health staffing gaps.
Operational Benefits of On-Demand Mental Health in the ER
On-demand telepsychiatry integrates seamlessly into your hospital’s existing workflows, making implementation straightforward for busy ER teams. From rapid onboarding to full EHR integration, virtual mental health professionals can triage, chart, and collaborate in real time, supporting your team without disrupting operations or requiring new technology.
- EHR Compatibility: Telepsychiatrists can document directly in your existing electronic health record system.
- Fast Implementation: Services can be onboarded quickly with minimal disruption to operations.
- Collaborative Approach: Virtual clinicians work hand-in-hand with your on-site nurses and providers.
- Streamlined Workflow: Clinicians can triage, chart, and round remotely, with optional medical director oversight.
- No Tech Barriers: We can work with existing equipment or assist in cost-effective deployment.
Challenges of Addressing Psychiatric Care in the ER
The utilization of ERs for mental health services presents unique challenges. Emergency departments were not originally designed to manage complex psychiatric needs, yet they’ve become a default destination for patients in mental health crises. This growing demand poses serious challenges:
- Limited Behavioral Health Staff: Many hospitals struggle to maintain 24/7 access to psychiatric professionals, especially during off-hours.
- ER Overcrowding & Boarding: Psychiatric patients often remain in the ED for hours—or even days—waiting for appropriate care or placement, tying up critical resources.
- High Acuity & Safety Risks: Patients experiencing severe mental health symptoms may pose a safety risk to themselves, staff, or others if not evaluated quickly.
- Stigma & Misdiagnosis: In a fast-paced ER setting, psychiatric symptoms may be overlooked or misunderstood, leading to inadequate or delayed treatment.
- Delayed Intervention for SI/HI: Without timely psychiatric evaluation, patients expressing suicidal or homicidal ideation may not receive the immediate treatment or safety planning they need, increasing the risk of harm.
These challenges highlight the need for a scalable, responsive solution that telepsychiatry services deliver.
On-Demand Mental Health Services for Your ER
Mental health conditions are a significant and growing concern in the ER. By understanding the most common diagnoses and the challenges involved in providing care, we can work towards improving the quality and accessibility of mental healthcare for those in crisis. Early intervention and comprehensive treatment are crucial for individuals with mental health conditions, and the ER plays a vital role in initiating this process.
Explore how on-demand psychiatry can reduce patient wait times, protect your staff, and improve care for psychiatric patients in your ER. Contact us to get started.
Frequently Asked Questions About Improving Care of Psychiatric Patients in the Emergency Department
How does telepsychiatry improve care for psychiatric patients in the ER?
Telepsychiatry provides immediate access to licensed mental health professionals who can assess, diagnose, and begin treatment remotely. This helps reduce boarding time, alleviates staff burden, and ensures psychiatric patients receive timely, specialized care, freeing in-person healthcare professionals to focus on critical medical emergencies.
How quickly can a telepsychiatrist evaluate a patient in the ER?
Many on-demand psychiatric programs offer response times within minutes to an hour, depending on the service level selected. This rapid access is particularly beneficial for hospitals without 24/7 in-house psychiatry coverage or during peak ER hours.
Is on-demand psychiatric care compliant with hospital regulations and standards?
Yes. Reputable telepsychiatry providers follow all HIPAA guidelines and clinical protocols recommended by the American Psychiatric Association (APA). These services are designed to meet hospital accreditation standards and integrate into existing workflows and EHR systems.
Organizations such as the American Telemedicine Association (ATA) and the Center for Telemedicine and e-Health Law (CTeL) also offer guidance and resources to support regulatory compliance and best practices in telepsychiatry.
Will telepsychiatry increase or decrease our hospital’s operating costs?
While you pay for the hours you bill to your mental health provider, hospitals often experience long-term savings through reduced patient boarding, lower readmission rates, improved throughput, and increased capacity for emergency care. Studies show mental health programs can yield up to $4 ROI for every $1 spent.