The Particulars: Previously published data indicate that rates of government support for community mental health services are low. In addition, state hospital bed reductions in North Carolina have led to substantial increases in psychiatric patient volumes and ED wait times. The impact of these changes on psychiatry residents who are practicing in EDs has not been evaluated.

Data Breakdown: A survey was conducted for 1 month in 2013 that explored resident experiences in emergency psychiatry. Survey questions addressed attitudes toward patient care and mental health policy, burnout, and future career plans. Among respondents, 81% rated finding patient dispositions from the ED as somewhat or very difficult. Patient length of stay in the ED was discouraging for 61% of residents at least once per shift. Only 22% rated the care they provided in the ED as very good or excellent. Three of every five respondents reported feeling burnt out from their work at least every few shifts, and nearly half said they felt more callous toward people every few shifts.

Take Home Pearls: Discouragement with patient length of stay and difficulty finding disposition for patients appear to be significant issues for psychiatry residents working in EDs. A substantial number of these residents appear to believe they are not providing high-quality care and feel burnt from with their workload.