Psychiatric patients who need hospitalization wait for hours in emergency departments for admission because hospitals are dropping mental health units and beds are scarce, a new survey says.

    Nearly 80% of hospitals said mentally ill patients sometimes wait four hours or more to be admitted, says the American College of Emergency Physicians, which surveyed 328 emergency medical directors. About 10% said patients wait more than a day on average.

    Average admission times for non-psychiatric patients were shorter: Only 30% of directors said those patients waited four hours or more. Yet 84% of the medical directors said ER wait times for all patients would drop if their hospitals had better psychiatric services.

    Only half of the hospitals surveyed had psychiatric units. The rest transferred patients, sometimes far from homes and families. Hospitals are closing their units because of inadequate payments from government and insurers, unpaid costs for the uninsured and too few psychiatrists willing to work in hospitals, says James Bentley of the American Hospital Association.

    Patients with mental illness "are the ones we hold the longest because there are so few psychiatric services available, and the ones that are available are overwhelmed," says David Mendelson, of the physicians group.

    The long waits can be troublesome for mentally ill patients, says Bruce Schwartz, director of psychiatry at Montefiore Medical Center in the Bronx, N.Y. "For individuals in need of admission because they're psychotic or severely depressed, it can be a very uncomfortable, scary, disorienting time."

    The survey found 61% of hospitals do not have psychiatry staff caring for ER patients while they wait, although they receive treatment for other medical problems.

    The poll comes amid growing concern about wait times and overcrowding in the nation's ERs, which experienced a 14% jump in visits for all illnesses and injuries from 2001 to 2005.

    Since 2000, the number of psychiatric beds in U.S. community hospitals dropped 12%, the association's statistics show. The number of hospital beds overall fell 4%.

    In March, the closure of Santa Rosa Memorial Hospital's psychiatric unit left California's Sonoma County without hospital-based care for mentally ill patients. Now patients must be taken 40 miles or more away to other hospitals.

    "It's not unheard of for people to spend a night or even a couple of nights (in the ER)," says Sonoma County Mental Health Services Director Art Ewart.