Managing increased demand for mental health services in a public hospital emergency department: A trial of ‘Hospital‐in‐the‐Home’ for mental health consumers

Kalucy, Ross S.; Thomas, Lyndall; Lia, Briony; Slattery, Terena; Norris, Diane

doi:10.1111/j.1440-0979.2004.00345.x

Cited by 30 publications

(34 citation statements)

References 9 publications

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“…Consistent with the findings of another Australian study [14], those of the present study may indicate that the absence of community-based CAT teams does not increase demand for emergency department services. Reporting on the changes to the model of care at Flinders Medical Centre in South Australia, Kalucy et al showed that a hospital-in-thehome service for mental health consumers was successful in diverting consumers from the emergency department and freed up inpatient beds.…”

Section: Discussionsupporting

confidence: 92%

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

et al. 2016

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This investigation focused on the impact of integrating crisis team members into community mental health services on emergency department and adult mental health inpatient unit demand within an Australian public health service. Mixed methods were used including (a) the comparison of service use data with that of two other comparable services (both of which had community-based crisis teams), (b) surveys of (i) patients and carers and (ii) staff, and (c) focus groups with staff. The numbers of emergency department presentations with mental health conditions and adult mental health inpatient separations increased 13.9 and 5.7 %, respectively, from FY2006/07 to FY2012/13. Between the three services, there were minimal differences in the percentages of presentations with mental health conditions, the distribution of mental health presentations across a 24-h period, and the triage categories assigned to these patients. Survey participants reported that patients used the emergency department due to the urgency of situations, perceptions that gaining access to mental health services would take less time, and the unavailability of mental health services when help is needed. Staff identified several issues (e.g. inappropriate referrals) that may be unnecessary in increasing emergency department demand. The integration of crisis team members into community mental health services does not seem to have produced an increase in emergency department admissions or inpatient separations beyond what might be expected from population growth. The potential may exist, however, to reduce emergency department admissions through addressing the issue of inappropriate referrals.

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Section: Discussionsupporting

confidence: 92%

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

et al. 2016

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“…29 In a trial of a "hospital in the home" service to relieve pressure on EDs, the authors reported positive outcomes on redirecting patients to intensive community-based mental health services, freeing up beds in the ED. 30 Due to limitations of the available database, comorbid substance abuse by patients with mental health issues in the ED was not studied. The association between comorbid substance abuse and psychiatric disorders presenting to a general hospital ED has been associated with substantially increased ED service usage.…”

Section: Models Of Carementioning

confidence: 99%

Clinical characteristics of people with mental health problems who frequently attend an Australian emergency department

Brunero¹,

Fairbrother²,

Lee³

et al. 2007

Aust. Health Review

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The objective of this study is to determine the clinical characteristics of people with mental health problems who frequently attend an Australian emergency department (ED). A retrospective clinical audit of presenter characteristics was conducted in a 550-bed tertiary referral metropolitan hospital with data reflecting 12 months of consecutive ED presentations between September 2002 and August 2003. A sample of 868 individuals accounted for 1076 presentations. Patients attending more than once accounted for 12.5% of the total sample. Significant variables associated with frequent attendance included: younger age; English speaking background; and mood and anxiety disorders. Lone arrival of a patient to the ED showed marginal significance. The significant associates of frequent attendance found in this study may be used to identify patients earlier to a multidisciplinary case review process and individual management planning involving clini- cians, carers and patients.

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“…The change in treatment preference has dramatically impacted upon the burden of care experienced by the family who have swiftly obtained responsibility from the mental health institutions to manage their care (Brand 2001; Carne 1993). Hospitalization of people with mental illness has also become brief as a result of a reduction in inpatient beds (Kalucy et al . 2004).…”

Section: Introductionmentioning

confidence: 99%

How involuntary commitment impacts on the burden of care of the family

Hallam

2007

Int J Mental Health Nurs

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Little research has examined how, or if, involuntary commitment has impacted on the burden experienced by the family. This paper reports a qualitative study which explored how involuntary commitment under the Mental Health Act (MHA) 2000 in Queensland, Australia impacted on families of people with mental illness. Family members of a person with a mental illness, under involuntary commitment at the time or in the previous 12 months, participated in focus groups. Thematic analysis was used to determine the themes. It was apparent from the views of the family that the use of the involuntary commitment was influenced greatly by the pressures experienced by the mental health services (MHS). The MHA did little to assist the family in gaining access to MHS. It was not until after the family made repeated attempts that they were taken seriously. Often the family had few options other than to use deceit and threats to obtain the necessary treatment required. In view of this, the inherit nature of what involuntary commitment implies for persons under it, such as refusing treatment and management difficulties, indicates the family with such an individual experience more hardship in trying to obtain assistance for that person. Thus, the MHA in Queensland has not met its goals of increasing access to MHS. Family members perceive that they were not being listened to and their concerns were not acted upon. The current culture of the MHS appears to serve, to a large degree, to estrange the family from the consumer making relationships difficult and time-consuming to repair. The mental health profession is urged to consider the culture within their workplace and move towards constructive involvement of the family.

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Managing increased demand for mental health services in a public hospital emergency department: A trial of ‘Hospital‐in‐the‐Home’ for mental health consumers

Cited by 30 publications

References 9 publications

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

Clinical characteristics of people with mental health problems who frequently attend an Australian emergency department

How involuntary commitment impacts on the burden of care of the family

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