Editorials, Opinion

Sen. Capito is right: Emergency mental health care needs help

We may not always see eye-to-eye with Sen. Shelley Moore Capito, but we wholly agree with her that emergency mental health care needs reform, and we applaud her bipartisan legislation, the Improving Mental Health Access from the Emergency Department Act. 

The bill, which she cosponsors with Sen. Maggie Hassan (D-N.H.), would create a grant program for emergency departments (EDs) to help acquire more resources or connect with local psychiatric services to help people who come to the emergency room while experiencing a mental health crisis. 

As we reported earlier this week, grant funds could be used for such things as: Expediting transition to post-emergency care through expanded coordination with regional service providers, assessment, peer navigators, bed availability tracking and management, transfer protocol development, networking infrastructure development and transportation services; increasing the supply of inpatient psychiatric beds and alternative care settings, such as regional emergency psychiatric units; or expanding approaches to providing psychiatric care in the emergency department — including tele-psychiatric support and other remote psychiatric consultations, peak period crisis clinics or creating dedicated psychiatric emergency service units. 

Too often, patients with mental health emergencies end up stuck in the ER for hours or days while they wait for a bed in a designated psychiatric unit or facility. Or worse — the patient in crisis is deemed not to be an immediate threat to themselves or others (as in, not actively hurting anyone, even if they are struggling with violent or self-destructive thoughts) and sent home without any help at all. And that is unacceptable. 

We’re thrilled to see one of West Virginia’s senators on the front line, fighting for better access to mental health care, especially in the emergency rooms where many people find themselves during a crisis. (And which may be the closest thing to any kind of health facility — mental or medical — some people can get.)  

The advantage of a grant system is it allows EDs to tailor their solutions to their individual needs. Some lack psychiatric beds and don’t have a safe place to put patients in crisis. Some lack in-house mental health services and need ways to connect patients to outside services. Some have the rough outline of a program to help patients with psychiatric emergencies but need assistance to see it fully realized. Some will need to start from scratch, and having funds available is half the battle. 

If we were to give any critique to Capito’s bill, it’s that the legislation establishes a “competitive” grant program. In other words, the funds will only be available to a select few. In an ideal world, we would like to see the grant program expanded to most, if not all, EDs and even to urgent cares in rural areas, since those are often the closest thing to a hospital’s emergency room for many outlying communities. 

Regardless, the Improving Mental Health Access from the Emergency Department Act is an excellent place to start. We hope Sen. Joe Manchin will support Capito’s bill in the Senate and that West Virginia’s two representatives will support it when it goes to the House.