Beyound Bedlam

Englewood — plagued by poverty, wracked by crime, and, according to former district police commander Maurice Ford, home to the largest number of mentally ill in the state — has only one hospital. That hospital, St. Bernard, boasts a specialized psychiatric emergency room, newly built in 1996, and featured on Nightline Monday night.

While the majority of the nation's psychiatric emergencies are handled in general emergency rooms, separate psychiatric ERs give uninsured patients direct access to care. Federal legislation enacted in 1986 — EMTALA, the Emergency Medical Treatment and Active Labor Act — bans any emergency facility from turning an uninsured patient away.

According to Mark Tryba, director of mental health services at St. Bernard Hospital, having "a separate ER for pysch patients really affords them the respect and dignity that all patients are entitled to."

A general emergency room can be a chaotic place for the mentally ill, but a specialized facility can o...