NUBE 2024

Confronted by diminishing outpatient resources, patients with psychiatric emergencies are forced to seek other avenues for treatment, including the healthcare system’s last remaining safety net—the emergency department (ED). As inpatient beds are scarce across the state and nationally, many patients spend several days or weeks in the ED without any acute behavioral therapy while they wait for an inpatient bed to become available. The current state of emergency psychiatric care calls for patient-oriented solutions focused on converting boarding time from wasted time to treatment time—initiating the healing process for our patients in distress presenting to the ED as a last resort.

Integration of psychiatric occupational therapy (OT) services to provide active treatment to ED boarding patients is a promising intervention. OTs are an integral part of psychiatric care in both inpatient and outpatient mental health settings. Their training and expertise uniquely position them to offer individualized treatment and assessment for patients with complex behavioral needs in the ED setting. Their treatment strategies include group and individual interventions to build coping skills, the integration of sensory modulation strategies into daily activities, and the promotion of engagement in healthy routines and behaviors. The use of occupational therapists in the emergency room setting for behavioral health patients has not been widely studied.

This presentation will be conducted by a multidisciplinary panel consisting of experts in rehabilitation services, social work, and emergency medicine. The panelists will reflect on their local experience of establishing a psychiatric OT consultation program in the ED. Drawing from their own research and programmatic expertise, the expert panelists will lead a case-based discussion to review: (1) how to financially and programmatically establish and support a psychiatric OT program in the ED, (2) how to integrate OT interventions into the delivery of care in the ED, and (3) what individualized treatment can be provided by OT during ED boarding. The panelists will also review local data on patient-reported outcomes.

Learning Objectives:

Understand different facets of psychiatric OT services that can be integrated into emergency psychiatric care in the ED.

Operationalize and support ED psychiatric OT consultation program.

Design individualized OT interventions, focusing on safety, treatment, reassessment, and patient empowerment.