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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

ORCID

https://orcid.org/0000-0001-9244-7595

Date of Award

Fall 2018

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

Advisor(s)

Maria G. DeValpine

Joy Harnage

Abstract

Introduction: Emergency departments are overburdened with mental health patients who lack adequate access to behavioral health resources. The influx of patients has led to an increased length of stay in the emergency department for patients who are being evaluated for mental health concerns. Overcrowding can lead to delays in treatment, undesirable medical events, and patient mortality. Crisis Intervention Team (CIT) models bring law enforcement, mental health providers, emergency departments, and individuals with mental illness together to improve care for patients in crisis. They have been instrumental in identifying patients in crisis and transporting them to a Crisis Intervention Team Assessment Center (CITAC), an integral link in CIT programs.

Methods: A retrospective chart review was done pre- and post-implementation of a Crisis Intervention Team Assessment Center in a 54 bed Emergency Department.

Results: Implementation of a Crisis Intervention Team Assessment Center in the emergency department may increase emergency department length of stay. Chi-square found no statistical significance between time to disposition and age, gender, type of insurance, or restraint usage. The presence of a police officer trained in de-escalating mental health patients may decrease the need for physical restraints for patients in crisis.

Discussion: The behavioral health system is lacking preventative resources needed to stabilize many mental health patients. Behavioral health patients in crisis have an increased length of stay in the emergency department. Implementing a team trained to efficiently evaluate and treat a patient in crisis is essential to ensure the patient’s safety.

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