Presentations to NSW emergency departments with self‐harm, suicidal ideation, or intentional poisoning, 2010–2014

Abstract

Objective: To evaluate population trends in presentations for mental health problems presenting to emergency departments (EDs) in New South Wales during 2010–2014, particularly patients presenting with suicidal ideation, self‐harm, or intentional poisoning. Design, setting and participants: This was a retrospective, descriptive analysis of linked Emergency Department Data Collection registry data for presentations to NSW public hospital EDs over five calendar years, 2010–2014. Patients were included if they had presented to an ED and a mental health‐related diagnosis was recorded as the principal diagnosis. Main outcome measures: Rates of mental health‐related presentations to EDs by age group and calendar year, both overall and for the subgroups of self‐harm, suicidal ideation and behaviour, and intentional poisoning presentations. Results: 331 493 mental health‐related presentations to 115 NSW EDs during 2010–2014 were analysed. The presentation rate was highest for 15–19‐year‐old patients (2014: 2167 per 100 000 population), but had grown most rapidly for 10–14‐year‐old children (13.8% per year). The combined number of presentations for suicidal ideation, self‐harm, or intentional poisoning increased in all age groups, other than those aged 0–9 years; the greatest increase was for the 10–19‐year‐old age group (27% per year). Conclusions: The rate of mental health presentations to EDs increased significantly in NSW between 2010 and 2014, particularly presentations by adolescents. Urgent action is needed to provide better access to adolescent mental health services in the community and to enhance ED models of mental health care. The underlying drivers of this trend should be investigated to improve mental health care.

A Pilot Study to Explore the Influence of the ‘Safety First Assessment Intervention’ on the Family Environment

“…The population characteristics of participants are similar to those described in other Australian reports relating to mental health presentations for young people, supporting the generalisability of our results, with females and young people who are Aboriginal or Torres Strait Islander being over‐represented compared with the general population (Perera et al., ).…”

Trend of emergency department presentations with a mental health diagnosis in Australia by diagnostic group, 2004–05 to 2016–17

“…Even so, the marked increase in presentations for unspecified mental disorder (F99) in NSW warrants further investigation. Further, as the jurisdictional collections and NNAPEDCD have historically only recorded one diagnostic code, there is an underestimation of the burden of mental health presentations, as self‐harm and suicide‐related presentations were coded as X60–X84 (intentional self‐harm), or U50–Y98 (external causes of morbidity and mortality), or even an injury code . In addition, the grouping of F00–F99 as mental health disorders has significant clinical limitations, given that presentations with a code of F00–F09 and F50–F59 are managed primarily by non‐psychiatric medical teams.…”

Burden of primary care‐type emergency department presentations using clinical assessment by general practitioners: A cross‐sectional study

“…In Australia, the Australian Institute of Health and Welfare (AIHW) previously considered a PCTED presentation to be any patient allocated an Australasian Triage Scale (ATS) of 4 or 5, not arriving by ambulance, police or correctional vehicle, not subsequently admitted or referred to another hospital, and who does not die . This indicator has not been reported by the AIHW since 2014 because of ‘limitations in the methodology used’, but it is still used elsewhere . Another method to quantify PCTED presentations relies on calculations of the number of self‐referred versus GP‐referred, non‐admitted, ATS category 3, 4 or 5 patients .…”

“…10 This indicator has not been reported by the AIHW since 2014 11 because of 'limitations in the methodology used', but it is still used elsewhere. 12 Another method to quantify PCTED presentations relies on calculations of the number of self-referred versus GP-referred, non-admitted, ATS category 3, 4 or 5 patients. 6 A third method relies on self-referred, nonadmitted, ATS category 4 and 5 patients with diagnoses on a list defined as potential GP cases.…”