- Almost half of the increasing ER use in New Jersey hospitals is being driven by patients with mental health and substance use disorder needs, according to a report by the New Jersey Hospital Association.
- The organization found ED visits in New Jersey to have risen by more than 117,000 patients from 2014 to 2015, and about 54,000 of those cases (45.7%) included a diagnosis of mental health or substance use disorder.
- The NJHA report added the 10.1% rise in these cases far outpaced the overall 3.8% rise in ED use during the study period.
The report looks at the contradiction in which more people than ever are covered by health insurance, yet more people continue to use hospital EDs for treatment, which have traditionally served as the go-to solution for the uninsured and underinsured.
The problem is a lack of access to appropriate resources for mental health and substance abuse treatment, despite strides in coverage, particularly through Medicaid expansion, said NJHA president Betsy Ryan.
"It's great that these New Jerseyans are covered by insurance, but we also need to make sure they have access to appropriate behavioral health services, in the right setting – and that setting should not be the emergency department," she said, because accessing EDs for mental health crises is shown to stress both the patient and the system, as well as increase healthcare costs.
The barriers to appropriate solutions, however, are many. The issues include lack of parity for mental health coverage compared to medical care despite laws that already exist, as well as lack of network adequacy, and a roadblock in some state Medicaid programs that prohibit payments for mental health and primary care services provided the same person on the same day.
Further problems exist around specific access to substance use treatment, and opioid treatment in particular, with most physicians simply referring such patients to addiction centers rather than helping address the epidemic head-on, in part because they are "set up for failure," according to a STAT news report.