Opinion: I work in a psychiatric ER. I’m watching the system fail people in real time

Dark purple. I see the chat bubble in the top left corner of the electronic health record on my screen flip colors. The change in hue represents a new message: urgent, perhaps, or just another patient who cannot sleep. As one of only two psychiatry providers overnight in the psychiatric emergency room, I know it is most likely a message beamed into the ether by a nurse located 15 feet away from me, locked inside a fishbowl similar to mine. A long row of eight desktop screens glows in the dim of the workroom. I am a third-year psychiatry resident, and my supervising attending psychiatrist and I sit at opposite ends of the worktop that runs lengthwise across the room. Decades of experience and the heavy scent of stale papers and bleach hang in the balance between us. Behind the dusty screens, a cork bulletin board is crammed with instructionals on how to fill out involuntary hold paperwork, draped communal stethoscopes, and grayscale printouts showcasing the staff’s pets. The occupational therapist’s bug-eyed goldfish and my attending’s regal twin tabbies, Sasha and Mischa, stare back at me from the wall. They are the only living things in the room that look relaxed.Read the rest…