After Decline in Clinic Funding and Psychiatric Beds, Denver ERs Overwhelmed by Mentally Ill Patients

Emergency rooms in Denver, Colo., have become "giant repositories" for the mentally ill, as city hospitals do not have the resources to cope with a steadily rising number of patients, the Denver Post reports. Denver Health Medical Center, for instance, saw an 18% increase of ER patients with psychiatric conditions in 2000 and a 28% increase in the number of mentally ill patients admitted to the hospital. Denver physicians say "up to 40% of psychiatric patients entering an ER don't need to be there, and 90% aren't admitted" to the hospital for inpatient care, the Post reports. However, a $7 million decrease in state funding since 1999 for community clinics and a decrease in the number of psychiatric beds in Colorado hospitals have left the mentally ill nowhere to go. Psychiatric beds have decreased by 1,000 since 1995 due to funding cuts and conversion to medical beds by hospitals. As a result, Denver mentally ill patients who go to Denver ERs "typical[ly] wait eight to 12 hours" due to a lack of beds and rooms. In addition, the decline in funding for community clinics causes them to turn away many uninsured residents with mental illness, thereby exacerbating the problems in ERs. "You don't have a fully stable discharge system because the community mental health system is backed up for six weeks or more," Joyce Kobayashi, director of HIV psychiatric services at Denver Health, said, adding, "We can't get the patients into appointments there. ... And we will see them again" in the ER (Sherry, Denver Post, 8/27). For further information on state health policy in Colorado, visit State Health Facts Online.