It was the tenth time Mary had presented to the emergency department (ED) suicidal and intoxicated after trying to subvert her depression with alcohol. This time, a caring bystander had called 911 as they saw her laying on the sidewalk mumbling and the ambulance had brought her to the one place that was open after hours—the ED.
Mary’s story is not unique; research shows that roughly one in four Americans suffer from a diagnosable mental illness. When complicated by other psychosocial conditions such as substance abuse, homelessness, or chronic medical conditions, our country’s medical care system can be disheartening to navigate. All too often, this leads to poor preventative care and eventually higher incidences of crisis events such as Mary’s. One term used to describe patients at such risk is “complex care patients.” Our current system of care for complex care patients isn’t working; a new approach is needed—one that accounts for these conditions and better leverages in-person connection to address them.
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