• James D Meyer, Alastair J S McKean, Rebecca N Blegen, and Bart M Demaerschalk.
• 1 Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
• Telemed J E Health. 2019 Jan 1; 25 (1): 18-24.

BackgroundEmergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation.IntroductionWe examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds).Materials And MethodsWe conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015.ResultsThe data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED.DiscussionBased upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed.ConclusionsEmergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

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