By Erin Nelson, MHA, Director of Strategy

After 35 days in silence, my uncle finally speaks: “I’m Suuuperman.”

I reply, with a smile, “Superman. Really!? Well, that sounds fun!”

And back to silence for another eight days while my family and I head back to the hospital waiting room, back home, back to work wondering when and if he will ever get better.

Lucky for us, New York State has some great mental health hospitals and we knew he was in good hands, but I’ve seen numerous facilities over the course of my career, and unfortunately most of them are nothing to write home about. On a regular basis I sit around the table with health system executives and show them the need for additional behavioral health capacity or the need for departmental redesign for patient and staff safety, yet these projects move toward the end of the priority list. I don’t need to rattle off the stats. We all know there’s a need, and that it’s growing, and that we keep hoping someone else will take care of it. As best said by Charlotte’s National Public Radio personality, Jeff Bundy, during NPR’s semiannual fundraising campaign, “Here’s why it should be you.”

  • Not all solutions take large capital investments. Because many behavioral health patients have addiction issues, start by looking in your own backyard at how your providers are prescribing opioids and other addictive drugs. Create standard protocols and set up a system to monitor extended use by these patients.
  • The National Alliance of Mental Illness (NAMI) states that one in five adult face mental health illnesses,[1] which means it’s likely a similar percentage of your workforce is in this bucket. Ensure you have the right resources in place to support your staff’s needs and aggressively market these within your organization. Train your supervisors to recognize signs of mental illness and create a secure environment for employees to seek help. Reduced absenteeism, improved productivity, and increased organizational loyalty and trust are only a few benefits of this approach.
  • I’ve heard many executives describe their obstetrics program as a loss leader. While OB programs attract a very specific population, mental health affects everyone: Young and old, rich and poor, healthy and sick. The opportunities to find a niche somewhere within these various populations and fuel downstream brand loyalty and revenue are endless. Take partnerships with school counselors for example. The same student who uses these services at school may very well sprain their ankle in their varsity basketball game and need an X-ray, an orthopedic specialist follow-up, and physical therapy.
  • Without good downstream solutions this population will inevitably enter your organization through its most expensive doors: the emergency department. If you’re lucky enough to have a strong network of resources, then you’ll stabilize the patient and get them the care they need. But if you’re like most organizations, these patients could board in your ED for anywhere from eight hours to eight months in some of the most extreme situations. When you start considering that the average cost of boarding each behavioral health patient in the ED is $2,264 (and that’s just for the boarding portion of their visit), the business case for alternative solutions looks a little more appealing.[2]   

The key for acute care providers moving forward is to identify appropriate partnerships and leverage existing community resources. We know the problem can’t be fixed overnight, and the “go-it-alone” strategy is a breeding ground for disaster. As our providers and communities work together to build the appropriate continuum of services, we’ll see a shift from an underfunded acute-care-based solution, to proactive, cost-effective, patient-focused solutions. 


[1] NAMI. Mental Health by the Numbers. https://www.nami.org/learn-more/mental-health-by-the-numbers.

[2] Zeller S and Mao RJ. “Telepsychiatry, Emergency Psychiatric Services Can Reduce Mental Health Patient Boarding.” ACEP Now. https://www.acepnow.com/article/telepsychiatry-emergency-psychiatric-services-can-reduce-mental-health-patient-boarding/,