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And no, er docs cannot do the mental health assessment themselves because they are busy treating asthma exacerbations, MIs, sore throats, abdominal pain, etc....they are not mental health workers.
Clearly you have some romantic notion that everyone else is busy saving lives. The reality is most of what comes to the ER is complete dross and is not in any way shape or form an emergency. I did my ED rotation at an academic center so I can only assume it would be much worse in a community hospital with no trauma, no provisions for seriously ill patients. For every STEMI there are 10 sprains, for every asthma exacerbation, 10 people with the cold, for acute abdomen about 10 people with mild gastroenteritis. Then add in all the malingerers, drug seekers, chronic pain patients, and abnormal illness behavior, and the drunks picked off the street. Quite frankly 'bizarre behavior' is more appropriate for medical evaluation than most.
That said, I don't think it is usually appropriate for someone who had SI to be waiting in the ED for 10 hours. But 'altered mental state', 'bizarre behavior', first 'panic attack' - yes it is not unreasonable for them to be seen in the ED. Where would you rather they go? We still occasionally get patients who are frankly delirious who have been 'medically clear' so the system is not foolproof as it is, we would have far more organic stuff coming through. Also I don't think it is ideal for someone established with a community mental health center to come to the ED and there should be other provisions if they need admission.