It is true that people who immigrate to the US may not ‘see’ their family for long periods of time, its unusual, however, for them to not be in touch at all. I find people in NYC Caribbean communities to maintain very close family ties, but then again, exceptions occur…. Its my brief experience as a Psych resident, that people with chronic mental illness lose contact with their families. its my observation that the more chronically disorganized and psychotic a patient becomes, the less family support they have. Its understandable. Family often do not have the understanding or resources to manage mental illness.

I do all my calls in the CPEP, which is a specialized psych ED, any my hospital. Comments about cots being available for psych patients as bad thing is uninformed. If my attending or I need to move people out of the CPEP because the pt doesnt belong there or needs to be admitted, they are moved. You get your share of malingerers, but in genreal most people come because they need to be there. Cots are needed and well utilized. Sometimes patients must rest or are sedated and therefor must be reclined.

I agree with the previous comment, if the pt was white (even of moderate income), this attention would have different meaning to it.

From the article: a woman in a hospital gown in the waiting area of the psychiatric emergency room

She was already a patient. It was a psych emergency room. You are knee-jerking about abuse of regular emergency rooms.

Did you read the article (DB Medical Rants; Happy Hospitalist) about long tails? You would benefit enormously from learning to examine details before you come to the same conclusion every time you see something familiar.

From the article: who had been waiting for a bed when she collapsed, had been involuntarily admitted the previous day for “agitation and psychosis,”

What is a patient who has been admitted involuntarily supposed to do if there isn’t a bed for them?

Your attitude is disturbing. You don’t seem to have much compassion for the struggles of people who have a disease they can’t control:

EE: We shouldn’t encourage they’re behavior by providing them a place to sleep.

Well there you go. Malingering psychotics shouldn’t have their behavior encouraged by providing them with a place to sleep when they’ve been involuntarily committed. Let them eat cake and sit up in chairs or pace the floors, but they will not be given a comfortable place to sleep lest, God forbid, they are encouraged to continue to be psychotic.

A bit of sarcasm, but I think having to wait 24 hours for a place to sleep where one had zero choice about the accommodations would make a lot of rational people nearly psychotic.

The point is that there is such a shortage of psych beds that people routinely wait 24-48 hours in the ED before being placed. Would you seriously begrudge a psychotic patient who is in the ED for over a day a cot to lie down on?

I also see no need to make fun of how certain patients talk.