A Study of Repeat Visits to a Psychiatric Emergency Room

Munves, Paul I.; Trimboli, Frank; North, Alvin J.

doi:10.1176/ps.34.7.634

Cited by 19 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As many as one-third of the patients admitted to a psychiatric emergency service are likely to return within the year. This proportion represents an increase from about 10. percent in the early 1970s and approximates the percentage of repeat users noted in the mid-1980s (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). If the use of inpatient psychiatric care is to be restricted under the auspices of managed care, it is crucial to better understand how specific factors associated with the patient's experience at the initial evaluation in the psychiatric emergency service and with interventions after the emergency visit may predict future involuntary returns to the emergency service.…”

mentioning

confidence: 56%

“…Demographic findings suggest that frequent users are more likely to be male (5)(6)(7)(8), unmarried (6,7,(9)(10)(11)(12), younger (6)(7)(8)13), nonwhite (7,14), and unemployed (6,7,12,15). Repeat users are also more likely to be unaccompanied or self-referred to the psychiatric emergency service (10)(11)(12)(13)16,17) and to have a psychotic disorder (5)(6)(7)(8)10,15,16,18), a history of previous psychiatric hospitalizations (7,9,13,16), and a history of current or previous psychiatric treatment (10,12,13,15,16). They are also more likely to be perceived as a threat or danger to self or others at the time of the initial evaluation (6,16).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Factors Associated With Involuntary Return to a Psychiatric Emergency Service Within 12 Months

Segal¹,

Akutsu²,

Watson³

1998

View full text Add to dashboard Cite

mentioning

confidence: 56%

mentioning

confidence: 99%

Factors Associated With Involuntary Return to a Psychiatric Emergency Service Within 12 Months

Segal¹,

Akutsu²,

Watson³

1998

View full text Add to dashboard Cite

“…Indeed, previous research has suggested that treatment in psychiatric emergency departments reduces admissions (7)(8)(9)(10)(11)(12)(13)(14)(15). Our data provoke further thought about the appropriate role of psychiatric emergency departments, especially in light of an earlier suggestion that the psychiatric emergency department should be reconceptualized as a "triage referral system" to reduce the number of patients with nonemergency illness episodes that are seen in these settings (42).…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5)(6)(7)(8)(9)(10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization.…”

mentioning

confidence: 88%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

View full text Add to dashboard Cite

6 68 85 5 O ver the past two decades, the organization and provision of mental health care have changed dramatically. The deinstitutionalization of mental health services has resulted in shorter stays in psychiatric hospitals and in larger numbers of psychiatric patients living in the community (1). Many communities have too few resources to help these patients (2). The number of psychiatric referrals to hospital emergency departments has increased, partly because of the general lack of linkage between institutional and community services (3). This trend has been observed both in the United States and in Europe (4).Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5-10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization. In previous studies, 24 percent of 262 patients (11) and 38 percent of 128 patients (12) with a recent hospital discharge were readmitted within three to six months. In a study of state hospital patients in Massachusetts, Fisher and colleagues (13) found a 50 percent readmission rate within four years of discharge among 5,610 patients. Early hospital readmission has been related to the presence of mental illnesses with poor prognoses (13-15), to poor quality of patients' social networks, and to patients' difficulties with hygiene at discharge (16).Early readmissions, however, may also reflect the quality of postdischarge treatment and care. Some unplanned psychiatric referrals could be explained by the unexpected and acute progression of the patient's mental illness, but the rest may result because the mentally ill person has been discharged from the hospital too soon or because follow-up in the community is ineffective.Lower readmission rates have been associated with the existence of follow-up services. For example, McIntosh and Worley (17) implemented telephone follow-up and aftercare groups for patients who were discharged from a psychiatric hospitalization. Fifteen months after the implementation of these services, these authors found a readmission rate of

show abstract

“…Psychotic disorders have been ' among the most consistent diagnostic correlates of repeat visits (2)(3)(4)(5)(6). Social factors have also been implicated as risk factors for recidivism (7,8).…”

Section: Introductionmentioning

confidence: 99%

A Study on Recidivism in the Psychiatric Emergency Room

Dhossche¹,

Ghani²

1998

Ann. of Clinical Psychiatry

View full text Add to dashboard Cite

Our goal in this retrospective study was to assess empirical risk factors for repeat visits to the psychiatric emergency room. This information may be useful for targeted prevention and cost-effective service planning. Over a 7-month period, 400 (18%) of 2212 patients were repeat visitors, accounting for 36% of all visits. A diagnosis of a psychotic disorder at the first visit was a risk factor for a repeat visit, especially in young patients. Substance abuse, as suggested by positive urine toxicology, decreased the likelihood of recidivism, but positive toxicology screens in young schizophrenic patients increased the chances of a repeat visit. In a 1-month consecutive sample of 311 patients, unemployment and homelessness were stronger correlates than a clinical diagnosis of schizophrenia. These findings support previous evidence that psychiatric emergency services are often used by underprivileged patients. We suggest that a rational preventive approach to reduce recidivism in psychiatric emergency services may include substance abuse treatment and case management for young schizophrenics and community outreach projects for socially disadvantaged patients. Compliance of recidivist patients poses a difficult task for case managers and community psychiatrists. More studies are needed to assess the efficacy of these interventions.

show abstract

A Study of Repeat Visits to a Psychiatric Emergency Room

Cited by 19 publications

References 12 publications

Factors Associated With Involuntary Return to a Psychiatric Emergency Service Within 12 Months

Factors Associated With Involuntary Return to a Psychiatric Emergency Service Within 12 Months

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

A Study on Recidivism in the Psychiatric Emergency Room

Contact Info

Product

Resources

About