In a startling revelation, the er boarding crisis gripping U.S. hospitals has reached new heights, with psychiatric patients waiting an average of 56 hours in emergency rooms for a bed. According to a May 2025 survey by the Associated Press, this marks a significant 12-hour increase since 2022, driven by a dire shortage of mental health beds. Trauma centers across the nation are sounding the alarm as patients in crisis are left stranded in ERs, unable to access the specialized care they urgently need. The situation demands immediate action.
A Growing Wait Time Crisis
The latest data from the Associated Press survey of 50 trauma centers paints a grim picture. Psychiatric patients, often in acute distress, are now enduring an average wait of 56 hours in emergency rooms before a bed becomes available. This is a sharp rise from the 44-hour average recorded in 2022, reflecting a worsening bottleneck in the mental health care system. These extended delays not only exacerbate patient suffering but also strain ER resources meant for other critical cases.
Bed Shortages at the Core
The primary driver of the er boarding crisis is a severe shortage of psychiatric beds. Hospitals are simply unable to accommodate the growing number of patients seeking mental health treatment through emergency departments. With nowhere to transfer these individuals, ERs become de facto holding areas, ill-equipped to provide the specialized care required. This systemic gap leaves vulnerable patients in limbo, often without proper treatment or stabilization during these prolonged waits.
Impact on Patient Care
Extended boarding times have serious consequences for psychiatric patients. Waiting over two days in a chaotic ER environment can intensify mental health crises, increasing risks of agitation, self-harm, or deterioration. Medical staff, while compassionate, are often stretched thin, juggling diverse emergencies with limited mental health training. The result is a care gap where patients in desperate need of psychiatric intervention receive inadequate support during critical moments.
Strain on Emergency Departments
The ripple effects of the er boarding crisis extend beyond patients to the functionality of emergency departments themselves. When psychiatric patients occupy ER beds for days, it reduces capacity for other urgent cases like heart attacks or trauma injuries. Overcrowding becomes inevitable, leading to longer wait times for all patients and heightened stress for staff. Trauma centers report feeling overwhelmed as they struggle to balance competing demands with limited space and resources.
Advocacy for Legislative Solutions
In response to this escalating issue, the American Hospital Association (AHA) is pushing for urgent legislative action. The organization has thrown its support behind HR 1448, known as the PEER Mental Health Act, which aims to address the bed shortage by unlocking $2 billion in funding. This money would be directed toward creating step-down units—transitional care facilities that can alleviate pressure on ERs by providing an intermediate level of psychiatric care.
Potential of Step-Down Units
Step-down units, as proposed under HR 1448, could be a game-changer in tackling the boarding crisis. These facilities would serve as a bridge between emergency care and long-term treatment, offering a safe space for patients who no longer require acute ER intervention but are not yet ready for discharge. By freeing up ER beds, such units could significantly reduce wait times and ensure psychiatric patients receive timely, appropriate care in a more suitable environment.
Broader Context of Mental Health Access
The boarding crisis is a symptom of a larger problem: inadequate access to mental health services in the United States. With demand for psychiatric care surging in 2025, the lack of infrastructure—beds, staff, and funding—has become glaringly apparent. Emergency rooms have become the default entry point for many in crisis, yet they are not designed to handle prolonged mental health cases. This mismatch underscores the urgent need for systemic reform.
Call for Immediate Action
As wait times climb and ERs remain jammed, the call for solutions grows louder. The AHA’s advocacy for HR 1448 represents a critical step, but broader efforts are needed to expand mental health resources nationwide. Policymakers, healthcare providers, and communities must collaborate to address the root causes of bed shortages and ensure that psychiatric patients are not left waiting in distress. The current state of emergency care demands nothing less than swift, decisive intervention.
For more information on the state of mental health care and hospital challenges, refer to resources from the American Hospital Association and ongoing studies by the Centers for Disease Control and Prevention.