Educating Virginia’s clinical leaders on mental health admissions guidelines
Last Friday, VACEP’s Bruce Lo, MD, FACEP met with a Virginia Hospital and Healthcare Association leadership forum comprised of state chief medical officers and physicians.
Lo educated clinical leaders on Virginia’s screening process — finalized in 2018 and known as the Medical Assessment and Screening Guidelines for Adults and Children. The Guidelines outline the process for psychiatric patient admissions from emergency departments to a psychiatric hospital, inpatient psychiatric facility, or crisis stabilization unit.
The Guidelines were developed over two years by a workgroup with representatives from the Virginia Department of Behavioral Health and Developmental Services (DBHDS), VACEP, and VHHA. In addition, feedback was sought from multiple behavioral health stakeholders throughout Virginia, including the Virginia Association of Community Services Boards.
Despite the agreed-upon Guidelines, Virginia emergency physicians regularly hit barriers with the psych Admissions team — typically a nurse or other staff member unaware of the official state process.
In particular, problems often emerge with Doc-to-Doc communication, a state law saying that if there are disagreements regarding assessment and screening needed prior to psychiatric admission, an emergency physician can request a direct communication with the admitting psychiatrist. In addition, there are often discrepancies among facilities that use checklists or processes that differ from the standardized Guidelines, which are meant to:
Remove the need for blanket testing on patients experiencing mental health crises
Reinforce the state law allowing for Doc-to-Doc consultation
Below, you can review and scroll through the six-slide presentation. You can also download a PDF version, and visit our dedicated Guidelines page for more information. The presentation was developed by Lo and Joran Sequeira, MD, FACEP (both pictured here), each of whom played a key role in creating the Guidelines. They also serve on the Guidelines’ Protocol Review and Monitoring Committee (PRMC).
