Access to psychiatric care is often discussed as a workforce problem. It is that, certainly. Rural communities know the shortage better than anyone. Yet from the emergency department, access looks more immediate and more human.
Richard Catanzaro, MD
I’m Richard Catanzaro, MD, Assistant Chief Medical Officer and Director of Psychiatry at Equum Medical, where I provide clinical leadership for virtual services and build telepsychiatry programs designed to expand access to mental health care.
Before Equum, I spent more than a decade leading hospital-based psychiatry as Chair of Psychiatry at Northern Westchester Hospital, with earlier roles spanning inpatient leadership at Rockland Psychiatric Center and at Montefiore Medical Center.
Building a durable telepsychiatry service line: from “coverage” to clinical reliability
Telepsychiatry is easy to start and surprisingly easy to get wrong. A few video carts and a call schedule can create the appearance of progress while leaving the ED and inpatient units frustrated. The difference between a program that merely exists and one that...
Staff satisfaction: telepsychiatry as protection against moral injury
Healthcare leaders often treat staff satisfaction as a “culture” issue. Culture matters. Still, front-line satisfaction is frequently driven by one question: Do I feel safe and supported when the situation turns volatile? Behavioral health crises test that support....
Rural transfers and outmigration: when behavioral health leaves town, the whole hospital feels it
Rural communities understand outmigration in a visceral way. Patients leave town for specialty care and too often don’t come back for follow-up. Families drive hours. Employers lose workers to untreated illness. Local hospitals become “stabilize and ship” sites, even...
ED boarding: the psychiatric symptom of a system that can’t decide
ED boarding is often described as a “behavioral health crisis.” Clinically, many patients are in crisis. Operationally, boarding is a symptom of something else: a delay in decision-making. Patients board when the system cannot determine, quickly and confidently, what...
Access to psychiatric care is a clinical outcome, not a slogan
Access gets discussed like a social virtue. In my daily work, psychiatric phenomena surface as physical symptoms—panic that drives one’s heart racing, agitation that sends one’s blood pressure climbing, or grief that settles into one’s chest like pain. When we can’t...