Emergency Room Wait Times
The provincial ER Wait Times Strategy takes a three-pronged approach to reduce emergency department wait times through providing appropriate alternatives to emergency room care; increasing capacity and improving processes within the ER; and speeding the flow of patients into inpatient beds. Mental health and addictions have been identified as one of the priorities for developing appropriate community alternatives.
Emergency rooms are an appropriate point of entry for some people experiencing a psychiatric or medical emergency. However, many people in crisis turn to emergency rooms due to a lack of other available options. A lack of access to community mental health services and supports, primary health care and community-based psychiatric care are key reasons for emergency room visits. Oftentimes, repeat emergency room visits are the result of hospitals having insufficient information to refer individuals to more appropriate and long-term services and supports in the community.
In addition, people presenting to an emergency room with mental health needs routinely experience stigma, regardless of whether they are seeking medical or psychiatric care. This stigma often translates into delays in receiving services and increased wait times.
Innovative strategies are being implemented in various areas across Ontario to address emergency room wait times for people with mental health needs, ranging from community-based crisis workers and discharge planners located in emergency rooms and inpatient settings, to peer support, case management and innovative community-based crisis programs.
How CMHA Ontario Is Addressing This Issue
CMHA Ontario, in partnership with five other provincial mental health and addictions organizations, provided advice to former Minister of Health and Long-Term Care George Smitherman on strategies to address ER wait times. See Addressing Emergency Department Wait Times and Enhancing Access to Community Mental Health and Addictions Services and Supports (May 2008).
CMHA Ontario raised the importance of addressing emergency room wait times for people with mental illnesses in our Submission to the Select Committee on Mental Health and Addictions, Legislative Assembly of Ontario (May 27, 2009).
CMHA Ontario examined the issue of emergency room wait times for people with mental illnesses in Mental Health Crisis: Time for a Compassionate Response, Network (Fall 2009). This issue of the magazine examines the roles of those who respond to a mental health crisis, including community mental health workers, the police and emergency room staff, and profiles several programs that offer alternatives for people in crisis.
CMHA Ontario joined with three other provincial stakeholder organizations in endorsing key strategies to address ER wait times. These strategies, as well as corresponding recommended actions, were outlined in a letter sent to the Minister of Health and Long-Term Care David Caplan. See Letter on ER Wait Times (September 30, 2009).
Reducing emergency department wait times for people with mental illnesses
- “Reducing Emergency Room Wait Times for People in Psychiatric Distress: Recommendations from the Schizophrenia Society of Ontario,” October 2008
Community Crisis System Research from the Systems Enhancement Evaluation Initiative (SEEI)
- Waterloo Wellington Crisis System Evaluation
- Do Clients Receive More Appropriate Care and Use Fewer Hospital Resources Now That the System Has Been Enhanced?
Community-based discharge planning
- An Evaluation of Community Based Discharge Planning: Report, Systems Enhancement Evaluation Initiative