Second Draft: Long Stays in Hospital Emergency Department (ED) Hallways

The Issue:

Peers have reported to the CCSM that they have had long stays in the hallways at local emergency departments across Maine. One individual spent 7 days sitting in the ED hallway. Lack of privacy and potential HIPPA violations due to hallway placement are substantial problems (for the individual in the hallway and other patients). This is not a trauma-informed process. There is a long and recurring history of this practice, and we know it can be done more compassionately and efficiently. 

Recommendations:

1. We need to eliminate the use of emergency departments for mental health, in general, and for crises (unless attempted suicide or other emergent issues). Primary care providers or centers like express care could be better utilized for these purposes. We can enhance our current capacity to address the multidimensional and sensitive needs of peers experiencing mental health challenges.
   a. Problems with hallway placement include a lack of safety and confidentiality.
   b. Consistency of timely medication dispensing, and potential medication mix-ups.
   c. Staffing-related problems such as but not limited to; lack of staff availability, being trained in Trauma Informed Care, and lack of Certified Intentional Peer Support Specialists (CIPSS)
2. We need a system that allows for medical clearance and psychiatric evaluations that allow for faster admission to psychiatric facilities (where privacy and safety can be maintained), preferably outside of the hospital setting
3. Preventative measures and increased accessibility to efficient help are the primary objectives of these proposed strategies.

Expected Outcomes:

1. To provide a reduction of negative experiences and outcomes. 
2. Provide more timely access to a higher level of appropriate triage care.
3. We expect them to provide trauma-informed care and CIPSS
4. There will be parity between physical and mental health care.

To submit feedback, ideas, or a personal story relating to this issue statement, please send it to the CCSM office either by mail at 219 Capitol St., Suite 7, Augusta, ME 04330, or email at [email protected].

DEADLINE TO RESPOND: Monday September 9th.