Dr. Jeff Louie

So thanks for having me, Stan. So yeah, there's two biggest issues that we're still enduring in the emergency departments. And these are the emergency departments in general, from our facility to other facilities in the Twin Cities and throughout the state, is the increased numbers of both mental health kids with suicide ideation, aggressive behavior, homicide ideation.

So thanks for having me, Stan. So yeah, there's two biggest issues that we're still enduring in the emergency departments. And these are the emergency departments in general, from our facility to other facilities in the Twin Cities and throughout the state, is the increased numbers of both mental health kids with suicide ideation, aggressive behavior, homicide ideation.

And there's a subset of those kids who are our residential placement kids who also have these mental health, problems, but they are not deemed to be eligible for admission to mental health inpatient units. But either the foster parents or their parents can no longer care for them at their homes or facilities cannot care for these kids at home because they're now too violent.

And there's a subset of those kids who are our residential placement kids who also have these mental health, problems, but they are not deemed to be eligible for admission to mental health inpatient units. But either the foster parents or their parents can no longer care for them at their homes or facilities cannot care for these kids at home because they're now too violent.

And so they come to our emergency department And just for safety issues, we just can't discharge them. So they board in the emergency department. So both mental health kids who don't have an admission just yet to go to inpatient facilities and the residential placement kids, are also boarding our ER for placement. So those are the two biggest issues right now.

And so they come to our emergency department And just for safety issues, we just can't discharge them. So they board in the emergency department. So both mental health kids who don't have an admission just yet to go to inpatient facilities and the residential placement kids, are also boarding our ER for placement. So those are the two biggest issues right now.

It's relatively new for... from the impact of COVID. And it's a multifactorial issue and it affected everyone across the country. I have medical director colleagues throughout the country and we all have the same problems in varying degrees. And if you recall, when COVID hit, there was the, what was it called? I can't remember specifically, it was called where you couldn't go to work, right?

It's relatively new for... from the impact of COVID. And it's a multifactorial issue and it affected everyone across the country. I have medical director colleagues throughout the country and we all have the same problems in varying degrees. And if you recall, when COVID hit, there was the, what was it called? I can't remember specifically, it was called where you couldn't go to work, right?

Locked to lockdown. And the lockdown affected everyone, right? Not only small businesses, but hospitals. And I've been thinking about this a lot last night. Matter of fact, I probably didn't get much sleep last night about the whole frequency, the timetable. So when COVID hit, there was a lockdown and a lot of things that would generate money or productivity for the hospitals went to zero.

Locked to lockdown. And the lockdown affected everyone, right? Not only small businesses, but hospitals. And I've been thinking about this a lot last night. Matter of fact, I probably didn't get much sleep last night about the whole frequency, the timetable. So when COVID hit, there was a lockdown and a lot of things that would generate money or productivity for the hospitals went to zero.

The ORs closed, inpatient units closed, critical care units closed. And so when you lose money, you have to start laying off people. And you lay off people, And then all of a sudden the lockdown ends and then a combination of being locked down and virtual school and social media, we saw a huge spike in mental health kids that we've never seen before.

The ORs closed, inpatient units closed, critical care units closed. And so when you lose money, you have to start laying off people. And you lay off people, And then all of a sudden the lockdown ends and then a combination of being locked down and virtual school and social media, we saw a huge spike in mental health kids that we've never seen before.

In our emergency department, we used to, in fact, my emergency department was never meant to, as well as most emergency departments, we are never meant to manage mental health kids at this volume. Literally, instead of one a day, we're seeing 15, 18 mental health evaluations a day.

In our emergency department, we used to, in fact, my emergency department was never meant to, as well as most emergency departments, we are never meant to manage mental health kids at this volume. Literally, instead of one a day, we're seeing 15, 18 mental health evaluations a day.

And that just burdened the whole system because with the influx and the rise of mental health kids, now there's a problem of inpatient bed units. And we have to remember that when COVID hit, a lot of the inpatient units basically closed down for a while and they lost consciousness. And now we have a problem of trying to hire physicians, nurses, mental health techs back into the unit.

And that just burdened the whole system because with the influx and the rise of mental health kids, now there's a problem of inpatient bed units. And we have to remember that when COVID hit, a lot of the inpatient units basically closed down for a while and they lost consciousness. And now we have a problem of trying to hire physicians, nurses, mental health techs back into the unit.

And they're having problems filling those beds, filling those units with the proper number of people. So then you got a backlog of everything. They can only take, only half the unit was full and they couldn't take any more until they hired more people. And we don't have space, then you start boarding the ED.

And they're having problems filling those beds, filling those units with the proper number of people. So then you got a backlog of everything. They can only take, only half the unit was full and they couldn't take any more until they hired more people. And we don't have space, then you start boarding the ED.

Is that correct? Right. And you're absolutely right. Emergency departments were never meant to manage mental health in a sense that to make the patient safe and then go home. We deal with acute problems, chest pain, burns, we manage them, we stabilize them, and then we transfer it to the inpatient units. And fairly, and most of the time within a timely fashion.

Is that correct? Right. And you're absolutely right. Emergency departments were never meant to manage mental health in a sense that to make the patient safe and then go home. We deal with acute problems, chest pain, burns, we manage them, we stabilize them, and then we transfer it to the inpatient units. And fairly, and most of the time within a timely fashion.