Emergency Room Visits For Mental Health Are On The Risebut The Er May Not Be The Best Recourse For Your Situation
The past decade has seen a dramatic increase in the number of Americans arriving at emergency rooms with mental health concerns. A report by the Healthcare Cost and Utilization Project found that ER visits for depression, anxiety and stress jumped 55 percent between 2006 and 2013. Visits by people with psychosis and bipolar disorder increased 52 percent.
Why the rise in ER visits for mental health? While some research has indicated that the overall rates of mental illness in the United States may have increased, some patients just may not know where else to go when they are feeling depressed or anxiousand they often dont start treatment until a crisis sends them to the ER, says Amy Faith Ho, MD, an emergency medicine doctor and assistant medical director at John Peter Smith Hospital in Fort Worth, Texas.
A lot of resourcessuch as therapy, community psychiatrists and mental health clinicsare simply not available in a lot of places, and as a result there is not a lot of prevention for mental health issues, Dr. Ho explains. Instead, we end up having to wait until the patients act out in a way that puts them into acute harm, and only then is the health community able to intervene.
When the ER is ill-equipped to help mental health patients The problem with this wait until it gets really bad strategy, according to Ho, is that many ERs dont have the resources to handle mental health emergencies.
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A Compassionate And Experienced Team
BMRC is the result of collaboration among Bangkok Hospitals top-flight team of psychiatrists, psychologists, psychotherapists, occupational therapists, psychiatric nurses and pharmacists, all of whom have extensive experience in providing care and treatment for patients with mental health and substance abuse problems. With our care, the patients are treated as a member of our family.
We also support a strong communication network among psychiatric patients. We make it a priority to educate family members and caregivers through our Consumer and Caregiver Consultation and Community and Family Reintegration programs.
This is an important and innovative approach to supporting, restoring and improving the health and mental wellbeing of patients so they can successfully return to their families, rediscover their own values and live in the world happily.
Why Might I Need To Go To Hospital
If you’re experiencing a mental health crisis, staying in hospital might be the best way to keep you safe and provide you with the level of treatment you need. This might be because:
- you need to be admitted for a short period for further assessment
- there’s a risk to your safety if you don’t stay in hospital, for example, if you are severely self-harming or at risk of acting on suicidal thoughts
- there is a risk you could harm someone else
- there isn’t a safe way to treat you at home
- you need more intensive support than can be given to you elsewhere.
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Why Does Anyone Really If Its Such An Uncomfortable Experience
The simplest answer I can give is that sometimes what we need to do and what we would prefer to do are two very different things.
And oftentimes, what we prefer overrides our judgment about what we need, which is why outside opinions like your therapists are so valuable in recovery.
Few people are excited to go to a hospital for any reason. But if I only did what I wanted to do, Id be eating Sour Patch Kids for breakfast and crashing childrens birthday parties so I could use their bounce house and eat their cake.
In other words, Id probably get arrested for trespassing.
I went to the hospital because the emotional and mental anguish I was experiencing had become more than I could handle. I needed help, and while I didnt want to get it in a hospital, I logically understood that was where I was most likely to find it.
If you can picture this scene: I waltzed right up to the emergency room attendant and said very casually, I wanted to jump in front of a train, so I came here instead.
Its not a conversation I ever imagined myself having, but then again, few people actually anticipate a mental breakdown or write a script for it.
I may have said it casually and probably scared the sh*t out of the attendant but deep down, I was terrified.
Its probably the bravest thing Ive ever done. And I have to be honest with you, too: I cant promise you that I would still be alive if I hadnt made that choice.
If youre on the fence, here are some things to consider:
Residential Treatment Vs Inpatient Mental Health Treatment
Treatment for mental health issues is available in a variety of settings. The right place for treatment depends on:
- the type of care you need,
- the severity of your mental health condition,
- your physical health, and
- your treatment plan.
Adults who need more intensive mental health treatment can seek care in a few different ways:
- Hospital inpatient: Short-term hospital inpatient care with specialized inpatient units for someone who is medically compromised and needs urgent medical attention for a mental health crisis.
- Residential treatment facilities: These facilities provide care outside of a hospital or medical facility. Many of these facilities help with drug and alcohol rehabilitation over several weeks or months.
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How Can I Access It
If you think staying in hospital could help you, then you can ask your GP, psychiatrist or another health care professional to refer you.
If you choose to go into hospital, you are considered a voluntary patient . This means that:
- you should have the right to come and go from the hospital
- you may discharge yourself if you decide to go home.
Unfortunately many areas have a shortage of available beds, so it might not always be possible for you to be treated in hospital – even if that’s what you’d prefer.
About locked wards
Locked wards are a kind of hospital ward where you can’t come and go freely.
- The doors may be physically locked, or you might need to get permission to leave the ward.
- Some wards might only be locked at certain times, but others may be locked all the time.
- Some locked wards have access to a secure outdoor space, like a garden or courtyard.
On most psychiatric wards there will be a mixture of voluntary patients and patients who are sectioned under the Mental Health Act. Health services have an equal duty to keep all these patients safe. For these reasons many psychiatric wards are locked, so if you are in hospital by choice you might feel like your freedom is more restricted than you would like.
If You Know Its Anxiety
If youve already been diagnosed with an anxiety disorder and are sure thats the cause of the current anxiety, then the considerations are different. Ask yourself what you hope to accomplish by visiting urgent care. Are you hoping to get a prescription for a fast-acting anti-anxiety medication? Are you hoping theyll refer you to inpatient care? Or do you just generally want help for what feels like an unsustainable level of anxiety?
Some of these hopes are more likely to be realized than others if you visit urgent care. It is entirely possible that you would be prescribed a fast-acting anti-anxiety medication, combined with a recommendation for continued care. Its unlikely, however, that you would be sent to a hospital for anxiety alone. And its unlikely youll leave your urgent care visit feeling like youve made irreversible and substantial progress against anxiety.
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Are People With Health Anxiety The Worried Well
There is a view, more prevalent in some places than others, that the people with health anxiety and similar symptoms have nothing seriously wrong with them and are just serial complainers. They are often given the collective title of the worried well. This is a misjudged expression. Those with health anxiety and associated disorders suffer greatly but usually silently. A proportion of them never seek advice at all, fearing that they have a serious illness but not having the nerve to put it to the test. The well-known film director, Tony Scott, jumped to his death from a bridge in Los Angeles in August 2012 believing he had inoperable brain cancer, but nothing was found on autopsy.24 Like many who have health anxiety, Scott had received treatment for cancer in the past but there was no sign of recurrence. He had not consulted a doctor in the recent past.
Longitudinal studies have shown that people with health anxiety die prematurely and also tend to get significantly depressed if untreated those who have had psychological treatment do not become depressed.16,25,26
Supportive Vs Unsupportive Friends
Should statements contributing to anxiety are often concocted in our own minds. Yet sometimes these should statements come from others, adding to anxiety and stress. These negative influences, or what might be considered bad relationships, can affect both your emotional and physical health.
As you think about your own thought patterns in order to lessen the shoulds, oughts, and musts, beware as well of comments from others such as “you need to,” “you should,” “you have to…” that can be defeating your peace of mind as well.
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Are There Over The Counter Anxiety Medications
Technically speaking, there are no over-the-counter medications available specifically for anxiety. That said, several remedies are available without a prescription that can help those struggling with anxiety or depression.
Supplements like GABA, Ashwagandha, or Valerian Root have been shown in some cases to be helpful. Be sure to talk with your doctor before adding a supplement, as there could be potential interactions with your current prescriptions.
Natural options such as CBD have been growing more and more popular over the last several years. Aromatic oils, like lavender, chamomile, and peppermint, have shown promise as well. Staying away from caffeine and excessive sugar can lower anxiety levels. Foods like nuts and healthy fats from fish or avocados are great foods for those with anxiety disorders.
Theres no reason to suffer through anxiety alone. If youre interested in anxiety medication then asking a doctor for anxiety medication is the next step.
Whats Generally Offered At Mental Health Inpatient Programs
One of the first services youll likely have at the hospital is an assessment with a psychiatrist. You may also be seen by a physician and have your bloodwork done. From there, the programs or treatment offerings at a mental health hospital can vary. Other services you may get could include:
-
Medication management
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One-on-one therapy sessions
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Is Health Anxiety More Of A Problem In Some Clinics Than Others
People worry more about their health when their symptoms are not easily visible or cannot be simply explained or resolved by common tests. So, in our research in secondary care, we have found that the highest levels of anxiety are found in patients in neurology, gastroenterology and cardiology clinics and the least in genitourinary medicine.15,17
The population is now being asked to take more responsibility for monitoring their own health. This is not unreasonable, but it puts a particular strain on those with health anxiety, as they are the ultimate health monitors, often checking many times a day on their pulse rates, their external orifices and what comes out of them, and anything else that can be conveniently measured. We have even had a patient who measured his abdominal girth every day because he was convinced his body was ripe for an explosion. The need to take action over warning signs is most prevalent for cardiac symptoms. When NHS information sites advise you to call 999 for an ambulance immediately if you develop sudden severe chest pain, patients with excessive health anxiety set a very low bar for such a call and also attend emergency departments frequently, but very few have any significant medical pathology.20,21 What is encouraging is that these patients appear to respond very well to psychological intervention, provided it is offered in an appropriate way.16,22,23
What Causes Hospital Anxiety
Hospital anxiety primarily crops up in adults for three reasons: a feeling of guilt, a loss of control, and a reminder of mortality.
Guilt occurs when a person understands that they havent been maintaining their health properly. Be honest: when was the last time you sought medical attention that wasnt immediately necessary? Do you get regular check-ups? If not, even if subconsciously, you might see hospital anxiety because you fear that you havent been properly taking care of yourself.
This goes hand-in-hand with the feeling you have lost control of your own health. When a person enters a hospital, they are leaving themselves in the hands of doctors. In many ways, this forces us to admit that we are not entirely invulnerable. As much as we consciously know that we arent, some part of us wants to believe that we are a superhero. Its hard to remember that its okay to be human.
Finally, and similarly, hospitals remind us of our own mortality. Unfortunately, death cannot be stopped only postponed. The fear of that moment encroaches on the lives of many, constantly lurking in the back of their minds. To live a healthy life, mortality must be embraced. Death is always a possibility, which should only be a reason to live as fulfilled as we can. Luckily, if mortality scares you, a hospital might be the most comforting place in the world.
The Cause of Hospital Anxiety in Children
Hospital anxiety occurs in children for an entirely different reason: children often fear pain.
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How To Admit Yourself To A Mental Hospital
- Jason Cannavo
If youve ever felt the panic of a mental crisis, then youve probably considered checking yourself into a mental hospital.
Mental illness is a prevalent reason for patients to visit the hospital. However, knowing when to admit yourself to a mental hospital and when its only an episode that will pass can be a crisis in itself.
If you find yourself in a situation where youre considering, should I go to a mental hospital, as a general rule, the reasons to be put in a mental hospital consist of:
- Actively having suicidal or homicidal thoughts.
- Actively hallucinating or unable to manage your mood swings in an outpatient setting.
- An inability to escape the pattern of addiction in an outpatient setting.
If you are unsure if you fulfill the criteria for an inpatient hospitalization, call your local mental health facility, which will examine your present needs and offer appropriate suggestions.
The prospect of committing yourself can be intimidating. However, if you know what to expect, this can help to alleviate some of the anxiety. With that in mind, were going to cover how to admit yourself to a mental hospital so you can get the care you need.
Rehabilitation For All Mental Health Problems
Good health begins with a healthy mind.
The value at BMRC is to provide the best care in consideration of both physical and mental wellbeing.
We have the capacity to care for patients with complicated medical problems such as heart disease, stroke and cancer who may develop mental health problems. This group of patients is often at higher risk of depression or behavioral problems, which could affect their recovery They benefit profoundly from the specialized care of our multidisciplinary team.
BMRC is expert team, is devoted to boosting mental wellbeing and helping people realize their full potential.
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Should I See My Primary Care Doctor For Mental Health Issues
Currently, most people seek out the help of their primary care physician for issues of mental health. In fact, recent studies have estimated that 70% of a primary-care doctors practice now involves management of psycho-social issues.
Why is this?
And, should this be the case?
Reasons Patients Tend To See A Primary Care PhysicianOne reason is ease and comfort. People have been conditioned by insurance companies to start with their primary care physician. In many ways, this is a good thing.
For example, many patients have developed a history and a trusting relationship with their family doctor and feel most comfortable when their doctor is coordinating care.
Others, however, are seeking to avoid seeing a specialist because of the stigma of depression which many fear could be discovered by an employer or nosy family member.
On the whole, patients seeking the care of a primary care physician is a net positive because there is so much need for mental health care in todays society. If primary care doctors didnt offer help, many people would go without it.
The Downside Of Not Seeing A PsychiatristWhile it was mentioned earlier that a large portion of a primary care doctors job deals with mental health issues, research has shown that only about 40% of people in treatment for depression actually get adequate care.
There are numerous reasons why this is the case.
Youre more likely to get the right diagnosis, the right treatment, and the right follow-up.
Be Well!
Know When It’s Time To Check Yourself In
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
If you’re experiencing severe depression symptoms, having thoughts of harming yourself or others, or your current treatment just isn’t helping, you may consider checking yourself into a hospital. Although this can be a frightening thought, you may find it less intimidating if you know what to expect from the process.
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