In response to "Mental Caseloads a Concern for M.D.s" (Nov. 4):
As president of the American College of Emergency Physicians and a Pennsylvania emergency physician myself, I share the concerns of my colleagues in this state regarding the lack of psychiatric resources.
The lack of psychiatric beds especially has led to admitted patients being boarded or held in the emergency department for 24 hours, and sometimes several days. This is bad for patients and contributes to dangerous overcrowding.
The author of a research paper published this year in the Annals of Emergency Medicine described ERs as de facto psych wards and said they are about the worst place for a psychiatric patient to wait for an inpatient bed. Unfortunately, it's getting worse.
The limited access to psychiatric care is creating a dangerous situation for every emergency patient.
Policymakers need to provide resources and support for emergency patients, because emergency visits are going to increase, despite health care reform.
ALEX ROSENAU, D.O