Changing demand for mental health services in the emergency department of a public hospital

Kalucy, Ross S.; Thomas, Lyndall; King, Diane

doi:10.1111/j.1440-1614.2005.01512.x

Cited by 18 publications

(14 citation statements)

References 10 publications

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“…The resulting variation in diagnostic descriptors is less than ideal. Australian studies among ED presentations have used varying methods to describe the patient presenting problem (Brunero et al 2007;Kalucy et al 2005;Meadows et al 1994). In this study, a content analysis of the diagnostic codes was conducted and all the codes used at the study site further categorized into larger presenting problem descriptions.…”

Section: Methodsmentioning

confidence: 99%

Profiling police presentations of mental health consumers to an emergency department

Lee

Brunero²,

Fairbrother

et al. 2008

Int J Mental Health Nurs

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Public mental health systems have been called on to better meet the needs of consumers presenting to health services with the police, yet few studies have examined police presentations among mental health consumers in large public mental health systems. This study was designed to determine the frequency profile and characteristics of consumers of mental health services brought in by police to an emergency department (ED) in Sydney, Australia. Using data from the emergency department information system and obtaining the psychiatric assessment from the medical record, we have examined trends and characteristics in mental health presentations brought in by the police to a general ED between 2003 and 2005. The sample consisted of 542 consumers with a mental health problem brought in by the police to the ED of a 350-bed community hospital. The characteristics of this group were compared with those of all mental health related ED presentations for the same period using logistic regression. Results indicated that police presentations are likely to be young males who are unemployed, have past and present alcohol and other drugs use, present after hours, and are admitted to hospital as a result of their presentation. These consumers are likely to have a presenting problem of a psychotic disorder, less likely to have a presenting problem of depression and/or anxiety, and given a triage code of three or higher. The study results highlight the importance of the availability of 24-hour access to mental health care to ensure a quick care delivery response. Police presentations to EDs with mental health issues are an indicator of significant impact on health services, especially with the current overcrowding of EDs and the associated long waiting times. Systems need to be developed that facilitate collaboration between EDs, hospital security, police services, mental health, and ambulance services.

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Section: Methodsmentioning

confidence: 99%

Profiling police presentations of mental health consumers to an emergency department

Lee

Brunero²,

Fairbrother

et al. 2008

Int J Mental Health Nurs

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“…The report identifies the demand on community mental health care and the relatively low number of inpatient beds as putting increased pressure on the interface of these Victorian EDs (Department of Human Services 2006). These examples help quantify the recurring theme that is evident in the literature that EDs have been subject to increased presentations by clients with mental illness (Broadbent et al 2002;Kalucy et al 2005;Stuhlmiller et al 2005;Webster & Harrison 2004). Despite the reported increase of mental health presentations to EDs throughout Australia and the issues surrounding the management of clients with mental illness in EDs, there are only a few examples of reported use of MHTS.…”

Section: The Use Of Mhts In Australiamentioning

confidence: 99%

The development and use of mental health triage scales in Australia

Broadbent

Moxham

Dwyer

2007

Int J Mental Health Nurs

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In Australian emergency departments, the triage of people with physical illness and injury is well developed and supported by the Australasian Triage Scale. The Australasian Triage Scale contains brief descriptors of mental illness and it is unknown if these provide the same reliability in triage decision-making for emergency triage nurses assessing people with a mental illness. Specialist mental health triage scales have been developed to cater for this deficit and to aid emergency staff who have lacked training in the assessment and management of people with a mental illness. A review of the development of mental health triage scales and their use in Australia identifies that using a mental health triage scale improves the competence and confidence of emergency department staff in triaging people with mental illness. Despite this, there is no consistent national approach to the emergency triage of people with a mental illness. There is ad hoc use of mental health triage scales and there are few reports of improvements in service provision to this client group as a result of the use of a mental health triage scale. These findings suggest that despite the intentions of the National Mental Health Strategy, a lack of equity remains in emergency departments in the provision of care to people with a mental illness who make up one in five of adult Australians. Consideration should be given to the introduction of a national approach to the use of a mental health triage scale in Australian emergency departments.

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“…Psychiatric patients represent a major challenge for EDs, 1 mainly because of their increased volume, 2,8,45,46 long ED LOS, 2,11,47,48 and high admission rates. 8,10 In our study, 97% of our patient population was admitted from the ED, with an average LOS of 37 and 76 hours for the JGH Waiting for a specific treatment 3 6.0…”

Section: 44mentioning

confidence: 99%

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

et al. 2015

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Objective: To describe the characteristics and needs prior to, on admission, during the first month in hospital, at the thirtieth day of hospitalization and posthospital discharge of psychiatric patients occupying acute beds.Methods: This prospective observational study was conducted in 2 tertiary care hospitals. Adult patients hospitalized on a psychiatric unit for 30 days were identified. Data was collected from their medical charts and interviews with their health care team. The categorization of acute and nonacute status at day 30 was based on the health care professional's evaluation. Descriptive and univariate analyses were performed.Results: A total of 262 patients were identified (mean age 45 years), 66% lived at home and 11% were homeless. More than one-half were cognitively impaired and a few had special medical needs. Ninety-seven per cent had been admitted from the emergency department. At day 30, 81% of patients required acute care, while 19% (95% CI 15% to 24%) occupied an acute care bed, despite the resolution of their acute condition. The main reason preventing discharge of nonacute patients was the difficulty or inability to find appropriate resources that met patients' needs. As for patients who required acute care, the most common psychiatric issues were delusions or hallucinations (34%), inability to take medications independently (23.6%), and inadequate control of aggression or impulsivity (16.5%). Conclusions:Prevention of the discharge of nonacute patients is largely due to the difficulty in finding appropriate resources that meet patients' needs. Improved access to community and subacute care resources could potentially facilitate the hospital discharge of psychiatric nonacute patients. W W W Caractéristiques et besoins des patients psychiatriques dont le séjour à l'hôpital est prolongéObjectif : Décrire les caractéristiques et les besoins, avant l'hospitalisation, au moment de l'admission, durant le premier mois, au 30 e jour d'hospitalisation et après le congé de l'hôpital de patients psychiatriques occupant des lits de soins actifs.Méthode : Cette étude d'observation prospective a été menée dans 2 hôpitaux de soins tertiaires. Les patients adultes hospitalisés dans une unité psychiatrique pendant 30 jours ont été identifiés. Les données ont été recueillies dans leurs dossiers médicaux et par des entrevues avec leur équipe de soins de santé. La catégorisation du statut aigu et non aigu au 30 e jour se fondait sur l'évaluation des professionnels de la santé. Des analyses descriptives et univariées ont été exécutées.Résultats : Un total de 262 patients ont été identifiés (âge moyen 45 ans), dont 66 % vivaient à la maison et 11 % étaient sans abri. Plus de la moitié étaient cognitivement déficients et quelques-uns avaient des besoins médicaux spéciaux. Quatre-vingt

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Changing demand for mental health services in the emergency department of a public hospital

Cited by 18 publications

References 10 publications

Profiling police presentations of mental health consumers to an emergency department

Profiling police presentations of mental health consumers to an emergency department

The development and use of mental health triage scales in Australia

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

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