Howard County General Hospital has begun a pilot program to admit involuntary psychiatric patients who come to the hospital's emergency room.
In the past, only those willing to sign themselves in voluntarily were hospitalized in the 20-bed psychiatric unit, even after police or a family member filed a petition to admit them against their will. The hospital has transferred roughly 170 involuntary patients a year by ambulance to other hospitals.
But finding an available bed elsewhere sometimes took days, particularly if the patient was uninsured. Hospital officials said they have kept such patients temporarily in rooms in the emergency department.
Under the pilot program, officials at the Columbia hospital are trying to quickly transfer involuntary patients into the psychiatric unit. Hospital officials said this week that they hope the program will relieve the growing strain on the emergency room.
Since 2002, the overall number of emergency room patients has increased by more than 12 percent, from an average of 158 a day to nearly 200 a day. The ability to admit involuntary psychiatric patients will free space for other emergency patients, hospital officials said.
Transferring patients into the psychiatric unit is also important for clinical reasons, said Joseph Schwartz, clinical director of the hospital's department of psychiatry. It is better to get patients out of the emergency room, which can be stressful, as quickly as possible, he said.
Since the program began Oct. 1, five patients have been involuntarily admitted. All of those patients subsequently agreed voluntarily to accept treatment, Schwartz said.
If a patient does not accept treatment after 10 days, a hearing is held with an administrative judge to determine whether the patient may continue to be kept against his will. The patient must go before a medical panel before he can be placed on any medication.
Involuntary psychiatric patients are frequently people who "calmly and articulately say they do not need to be in the hospital," Schwartz said.
But most "realize as they get treatment that they need the help. Very few will go to hearings," he said.
The nine-month pilot program is not expected to make money for the hospital. But hospital officials will be studying whether the program could jeopardize the finances of the psychiatric unit overall.
Psychiatric patients at the hospital are less likely to be insured.
Although 5.2 percent of all patients at the hospital are uninsured, that number rises to 22.2 percent in the psychiatric unit. This disparity makes the psychiatric unit more expensive to operate.
After six months, the program will be reviewed by the hospital's executive management team to determine whether it will become permanent.