The Changing Health Policy Environment and Behavioral Health Services Delivery.

Deinstitutionalization has left an inadequate supply of inpatient psychiatric beds. Simultaneous cuts to public funding and insurance coverage for outpatient mental health treatment have increased the frequency of acute psychiatric crises. The resulting lack of available options has shifted the burden of treatment to emergency departments and the criminal justice system. Recent legislation has improved insurance access, but rules are not always enforced and there are still few options for care. Discussion of mental health care delivery must acknowledge that many emergent behavioral health crises arise in the context of acute substance intoxication, withdrawal, or dependence.

Health Policy Considerations in Treating Mental and Behavioral Health Emergencies in the United States.

In recent years, health care providers have sounded the call that the US mental health system is in crisis. With decreases in funding and eroding access to care, the availability of psychiatric services has become increasingly limited, failing to meet growing needs. This article provides a brief history of mental health services in the United States and describes the current landscape of US psychiatric care; it touches upon some of the most important policy considerations, describing some of the glaring issues in US mental health care today. Last, it offers some potential remedies to improve care in acute behavioral emergencies.