Quality Matters: Navigating Behavioral Health Care in Hospitals Amid Growing Demand

The demand for quality behavioral care in hospitals has never been more urgent. As hospitals grapple with surging mental health needs and increasing complexity, it's crucial to ensure every patient receives the right care for their needs. 

Consider this scenario: A patient arrives to the ED and is medically cleared by the ED physician. But there is no psychiatrist available to evaluate the patient’s behavioral health concerns, including thoughts of suicide.  

The ED doc admits them in the interest of safety. Without an inpatient bed available, the patient endures a long wait time. They may be sedated, and they likely aren’t receiving treatment to advance their care. As a result, they can languish or their condition may worsen, which isn't good for them, for staff, or for other patients awaiting care.   

This scenario is not uncommon. Research shows ED visits for mental health diagnoses have soared, with lengthy stays and long wait times becoming more common: 

• Between 2017 and 2019, the percentage of ED visits lasting 4 hours or more was higher for adults with mental health disorders. 
• A national study between 2009 and 2015 found mental health ED visits were more likely to result in admission or transfer, and to last over 6 or 12 hours (with higher wait times for admissions and transfers).  
• Half of all mental health-related hospital admissions and 60% of hospital discharges are associated with repeated ED visits for the same or similar concerns. 

How to create the right solution beyond behavioral staffing 

Timely access to quality behavioral care can streamline ED operations, reduce unnecessary admissions and length of stay, and improve throughput and bed availability.  

While staffing for specialists in mental health may seem like the answer, it's not always feasible or effective given the highly competitive recruitment landscape for behavioral health clinicians. Organizations may face major challenges in hiring and retaining talented candidates. 

The best option is a comprehensive virtual behavioral health solution designed to improve clinical outcomes for patients and operational efficiency for hospitals. Through a virtual care model, hospitals benefit from timely access to a team of psychiatrists for psychiatric assessment, care, and risk-informed disposition recommendations. 

Virtual psychiatry can help enhance care and improve outcomes, but choosing the right partner is important to making a meaningful difference,  

Providing quality behavioral care for improved outcomes 

From completing patient assessments within the ED to meeting Zero Suicide requirements, Array can serve as a strategic support for achieving behavioral care and organizational goals. Our psychiatrists specialize in managing acute psychiatric patients and deliver high quality, evidence-based care rooted in best practices.  

We provide:  

• Psychiatrist-led assessment and level-of-care determination: Array psychiatrists evaluate the level of risk and make informed treatment and disposition decisions, allowing patients to be quickly directed to a clinically appropriate and effective setting.  

• Specialty interventions and management: Array psychiatrists prescribe medication and initiate stabilizing treatments according to established protocols. They virtually reassess patients daily to advance their care and determine if they are safe to discharge. 
• Proactive safety planning and care management: Array clinicians consider behavioral health resources available in your community and engage with your care coordinators to make more informed disposition decisions. This helps facilitate timely, safe, and effective care transitions. 

“At Array, we don’t just rubber stamp disposition decisions. Rather, our clinicians will take the time to thoroughly assess the patient, treat the patient if needed, and recommend a disposition that aligns with their level of risk. Our psychiatrists actively manage patients from the initial consult through disposition and safety planning,” said Dr. Mark Alter, Chief Medical Officer of Acute Care at Array. 

Array clinicians can restart home medications and initiate stabilizing treatment as needed. They reassess risk and disposition daily to determine if safe discharge is possible. “This proactive care approach transforms the patient’s journey and measurably reduces reliance on psychiatric inpatient resources and length of stay,” said Dr. Alter.  

Informing better patient disposition decisions 

Array provides more than just clinicians; we're partners committed to excellence in behavioral care. Our industry-leading quality program ensures safety and standardized care at every step.   

Our protocols help ensure the most risk-aware, least restrictive level of care disposition recommendation. By managing behavioral health patients throughout their stay, staff and resources can be freed up and redirected to other areas of priority. 

“With Array, you can access a perspective that extends beyond how the patient is presenting to onsite healthcare staff. We collect patient collateral, including their history and information from close relatives. This data better informs risk stratification and treatment decisions, optimizing the use of scarce behavioral health resources,” said Dr. Alter. 

Reducing inappropriate admissions affects patient care and hospital revenue. By providing rapid access to the right level of psychiatric care for behavioral patients, resources can be pivoted to other priority areas of care and to patients requiring prompt attention, like those presenting with stroke, acute myocardial infarction, or sepsis.  

Research shows that even a one-hour reduction in overall ED boarding time could result in $9,693 to $13,298 of additional daily hospital revenue by capturing patients who left without being seen and diverted ambulances.  

One study found that, mainly due to typically longer length of stays among psychiatric patients awaiting specialist care, the financial impact of psychiatric boarding accounted for a direct loss of $1,198 in revenue (compared to non-psychiatric admissions). 

Unburdening overstrained hospital staff 

Array clinicians follow the Zero Suicide Model and screen for suicide in all encounters, which supports Joint Commission requirements. In the process, lives can be saved. “Suicide screening needs to become a part of routine primary healthcare, like listening to someone’s heart,” said Dr. Alter.  

Array’s impact extends beyond the ED.  For more than two decades, Array has been a pioneer in psychiatric telemedicine and an advocate for expanding access to behavioral and psychiatric care for all.  

Through innovative service models and strategic partnerships across the system of care, we're breaking down siloes, overcoming fragmentation, improving outcomes, and making more meaningful connections to care.   

Join us in our mission to transform behavioral healthcare. Together, we can make a difference—one patient, one community at a time.