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April 27, 2016

Hospitals turn to mental health professionals to improve care quality, reduce length of stay

Daily Briefing

Some leading hospitals are placing mental health professionals in medical units to identify psychological issues early in patients' stays, Lucette Lagnado reports for the Wall Street Journal.

Hospitals typically bring in psychiatrists to consult on specific cases when a patient is experiencing a crisis. However, studies suggest that the routine presence of mental health professionals can improve care and reduce the time a patient stays in the hospital.

Philip Muskin, a professor of psychiatry at NewYork-Presbyterian/Columbia University Medical Center who led a study on the hospital's mental health program, says, "It is tough to have cancer. It is tough to have surgery. You want to chat about it. A lot of psychiatry is chatty."

Hospitals test new programs

Several hospitals in recent years have adopted mental health programs to better address patients' needs, including:

  • Johns Hopkins Hospital, which this month launched a program that screens patients for psychological disorders shortly after admission;
  • Brigham and Women's Hospital, which last fall began assigning a psychiatrist to a medical intensive-care unit;
  • NewYork-Presbyterian/Columbia University Medical Center, which includes a psychiatrist on providers' morning rounds; and
  • Yale-New Haven Hospital, which created a so-called behavioral intervention team that is led by a psychiatrist and includes a social worker, nurse practitioner, or other mental health professional.

Supporters of the programs say they are cost-effective because they help to reduce patients' overall length of stay. For example, a recent study of a NewYork-Presbyterian/Columbia program found that only 34 percent of patients studied stayed in the hospital for more than five days, compared with 59 percent of patients prior to the program's implementation.

Hochang Lee, chief of psychological medicine at Yale-New Haven Hospital, who has studied the economic effects of the hospital's program, notes that stay length dropped by "a little more than half a day" on average when the hospital started using the mental health team to address patient behavioral health issues proactively.

However, James Levenson, a professor of psychiatry at Virginia Commonwealth University, says it is hard to prove that adding mental health professionals saves hospitals money. He also notes that "serious mental disorders don't get better" after just a few psychiatric visits, adding, "What we should be showing is that we are improving mental-health outcomes" (Lagnado, Wall Street Journal, 4/25).

How you can be proactive at managing behavioral health


See our study on how hospitals can be proactive at managing behavioral health, and this accompanying video on why that matters so much—not just for patients' mental state, but for their physical health too.

The Daily Briefing also has covered how some hospitals are redesigning their facilities as they try to prevent patient suicides.


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