The American College of Emergency Physicians says patients routinely wait too long for inpatient psychiatric care.

Data from a survey of 1,700 emergency department doctors was presented at ACEP's annual meeting in Las Vegas in mid-October. Of doctors who responded to the survey, 21 percent said psychiatric patients routinely wait two to five days for an inpatient bed. Half of physicians said the situation for psych patients has worsened over the past year.

"The emergency department has become a dumping ground for these patients who have been abandoned by every other part of the healthcare system," said Rebecca Parker, a Chicago emergency physician and president of ACEP.

Many psych patients end up being transferred to another facility, but the wait time still exceeds that of medical patients in need of transfer.

One 2016 study found people who visit the emergency room for mental health services were transferred to other facilities six times more often than people with strictly medical complaints. The average length of stays for psych patients admitted for observation was 355 minutes, versus 279 minutes for medical patients. Psych patients who were transferred waited an average of 312 minutes compared to 195 minutes for all other patients.

The problem is caused by a lack of inpatient and outpatient resources. Beginning in the late 1960s, thousands of inpatient mental health facilities began closing, and appropriate resources have not filled the void. Between 1970 and 2006, state and county psychiatric facilities in the U.S. decreased bed availability from approximately 400,000 beds to fewer than 50,000.

"There has been progress made recently as the number of hospital-based psychiatric ER units has increased, along with regional psychiatric emergency care facilities that can quickly take in patients who visit local ERs," said Dr. Jane M. Zhu, a National Clinician Scholar in the department of General Internal Medicine at the Perelman School of Medicine at the University of Pennsylvania, and a fellow at Penn's Leonard Davis Institute of Health Economics. Zhu was the lead author of the 2016 study that looked at transfers of psych patients out of hospital ERs.

"However, these improvements have yet to offset the overall shortage of psychiatric inpatient resources," she said. "Overall, the study highlights the degree to which emergency departments struggle to meet the needs of mental health patients."

A 2015 study in North Carolina found 356 additional inpatient beds were needed to relieve overcrowding in ERs located in the central part of the state. Data from North Carolina's Department of Health and Human Services show the average wait time for an inpatient bed was longer than three days for the period from July 2014 to March 2015.

In some states, efforts are being made to address psych patients' needs in the ER.

A hospital in Alabama created a specialized unit within the ER to relieve crowding and better serve psych patients. In Billings, Montana, a new short-term stabilization unit was being implemented at a hospital that saw an increase in psych evaluations from 3,653 in fiscal year 2014 to 3,898 in 2015. Another facility in Minnesota is building a second "safe room" where violent psych patients can be housed away from other ER patients.

"We've been forced to adapt creatively, like everyone else," said David Schmoyer, director of the emergency department at United Hospital in St. Paul. "Still, from a human perspective, this isn't right. People were not meant to stay here day after day after day."