Cutler Institute for Health and Social Policy

Population Health and Health Policy

Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms


Context: National data demonstrate that mental health visits to the emergency room (ER) comprise a small, but not inconsequential, proportion of all visits; however, we lack a rural picture this issue.<p></p>
Purpose: This study investigates the use of Critical Access Hospital (CAH) ERs by patients with mental health problems to understand the role these facilities play in rural mental health needs, and the challenges they face.<p></p>
Methods: We collected primary data through the combination of a telephone survey and ER visit logs. Our sampling frame was the universe of CAHs at the time the survey was fielded.<p></p>
Key Findings: 43% of CAHs surveyed operate in communities with no mental health services, while 9.4% of all logged visits were by patients identified as having some type of mental health problem. The most common problems identified were substance abuse, anxiety and psychotic disorders. Only 32% of CAHs have access to onsite detoxification and 2% have inpatient psychiatric services, meaning that patients in need of these services typically must leave their communities to gain treatment.<p></p>
Conclusions: The lack of community resources may impact CAHs ability to assist patients with mental health problems. Among those with a primary mental health condition 21% left the ER with no or unknown treatment, as did 51% of patients whose mental health condition was secondary to their emergent problem. Patients in need of detoxification or inpatient psychiatric services often must travel over an hour to obtain these services, potentially creating significant issues for themselves and their families

Publication Type: 
Journal Article
Publish Date: 
April 1, 2007

Profile of Rural Residential Care Facilities Chartbook

Profile of Rural Residential Care Chartbook Cover

Using data from the 2010 National Survey of Residential Care Facilities, this chartbook from the Maine Rural Health Research Center presents information on a slice of the rural LTSS continuum—the rural residential care facility (RCF).  Survey results identify important national and regional differences between rural and urban RCFs, focusing on the facility, resident and service characteristics of RCFs and their ability to meet the LTSS needs of residents.

Learn More

Hartley Retires as Director of the Maine Rural Health Research Center

David Hartley, PhD

David Hartley, PhD, the Director of the Maine Rural Health Research Center (MRHRC) and a Research Professor of Public Health has announced that he will be retiring from the University of Southern Maine August 31st, 2014. David came to the University in 1994 and has directed the MRHRC since 2004. Andy Coburn, PhD, Research Professor of Public Health, will take over as the new MRHRC Director. Erika Ziller, PhD continues in her role as Deputy Director. David has had a distinguished career in rural health and rural health research, and has made lasting contributions to the field with his work on rural behavioral health, rural disparities and health, and rural active living.

A celebration will be scheduled in early fall to honor David and his many contributions to the field and the University.


Learn More

Connect With Us