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This paper seeks to discuss the challenges of boarding and steps to reduce boarding of psychiatric patients in emergency rooms. Boarding has become a huge problem in emergency rooms due to the rising rates of psychiatric patients. In the early 1960s, a deinstitutionalization movement led to the reduction of the number of psychiatric beds both for inpatient and residential in mental hospitals in the county and the states.  The number of beds dropped from an estimate of 400,000 in 1970 to 50,000 in 2006 countrywide.(Alakeson, Pande & Ludwig, 2010) The increasing number of psychiatric patients in hospitals has resulted in overcrowding of emergency rooms. The term boarding is used to refer to the time spent by the psychiatric patients in emergency room while waiting for medical clearance and available beds in outside psychiatric facilities. Additionally, emergency room staff including Dr’s and nurses do not have the required skills for performing psychiatry assessments and this has contributed to longer holding times. Therefore, the inadequate resources and lack of training by the……..

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