WEST BATH — We live in a nation where the parents of a hospitalized teenager who has expressed suicidal ideation struggle with not only the tormenting idea that their child had contemplated taking his own life, but also with the worry of how they will be able to afford an emergency room bill.

Mobile crisis units travel to various locations, providing crisis assessments to individuals in need of services. Because the mobile units are available, costly emergency room bills are not always necessary.

So why is this continuing to happen?

A lack of knowledge in regard to the various options for an individual in crisis continues to display itself, with a very costly unveiling.

A lack of awareness and education surrounding mental health within the community leads to numerous unnecessary ER visits. All too often school systems, family members and even primary care physicians are directing individuals to the ER as a last resort, when an assessment by a certified crisis clinician would be sufficient.

Certified crisis service providers are flexible and mobile, traveling to various locations. Some of these locations include schools, prisons, the primary care office and the family home.

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In addition, the agency where the mobile crisis unit is based is open for walk-ins and assessments.

It is this same flexibility that can save numerous individuals who are already in an extremely vulnerable state (whether insured or uninsured) from incurring the extreme and unnecessary medical bills that arise from a potentially unnecessary ER visit.

According to The Washington Post, research has found that the average charge for an uninsured emergency room visit is $1,233. With the average American rent currently at $871 per month, this makes the average ER visit a little more than 40 percent higher than that of the average American rent.

With this information, it is time to start asking how this disparity can be addressed. Community awareness appears to be the initial step in this process.

Although there are appropriate circumstances in which a client is required to be medically cleared, a large majority of the mental health cases seen within the ER are ones in which a crisis assessment could have been conducted in a less stressful, more cost-efficient environment that does not result in hospitalization.

On the micro level, educating individuals within the overall community on the services offered by a mobile crisis team would be a great place to start. Not everyone within the community is necessarily aware of these services, or even the existence of mobile crisis.

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It seems that the most instinctual place for outreach during a crisis is the ER, which does, in fact, make sense. If individuals are appearing as definite and immediate dangers to themselves or others, then this would be an appropriate next step.

There are many times, however, when the ER is simply used as a meeting place for individuals who are just feeling hopeless and in need of being heard. And it is a very expensive meeting place, at that.

This awareness could help individuals in crisis, as well as their family members, peers, faculty or coworkers have the appropriate knowledge in recognizing whether or not the ER is the best option for their personal circumstances.

At the macro level, societal institutions such as school systems, prisons and primary care offices would also benefit from this same awareness, as a mobile crisis team offers the very same services within the confines of one of these institutions, as opposed to that of the ER.

If, for some reason, hospitalization is necessary, the crisis worker has the ability to make that assessment prior to the individual even entering the hospital. It can often take hours for an individual in crisis to receive a bed in the ER, be medically cleared and then assessed by a crisis worker, all of which could be unnecessary and costly when the individual simply needs to be heard.

Individuals in crisis are in an extremely vulnerable state. Their top concern should be that of having their safety assessed, receiving the appropriate mental health support and working to obtain a stable and more peaceful state of mind. If it is possible for this to be done without worrying about how one will cover the outrageous expenses of an ER visit, then the question remains, why is this not happening?

— Special to the Press Herald


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