Psychiatric Emergency Services in a Canadian City: I. Prevalence and Patterns of Use

Oyewumi, L. Kola; Odejide, Olabisi A.; Ss, Kazarian

doi:10.1177/070674379203700203

Cited by 71 publications

(29 citation statements)

References 7 publications

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“…Nevertheless, a few findings deserve attention. The patients in this study were more likely than those in general epidemiological samples of patients seen in psychiatric emergency departments to be unemployed and living alone (5,23,31,32). Diagnostic profiles of patients in this study also differed from the general diagnostic profile seen in psychiatric emergency services (33).…”

Section: Discussioncontrasting

confidence: 38%

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

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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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

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Section: Discussioncontrasting

confidence: 38%

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

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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“…Effective emergency psychiatric units mitigate the need for longer hospital stays by improving the operation of the network itself. 26 Furthermore, hospitalization restrictions for cases where a patient really needs to be hospitalized can determine the organization of the service network and of the flow of patients. 27 The total number of admissions per each year remained practically stable until the last years of the study, probably because of health network organization through hospitalization service.…”

Section: Resultsmentioning

confidence: 99%

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Barros

Marques

Carlotti

et al. 2009

Rev. Bras. Psiquiatr.

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Objective: Characterize and compare acute psychiatric admissions to the psychiatric wards of a general hospital (22 beds), a psychiatric hospital (80) and of an emergency psychiatry unit (6). Method: Survey of the ratios and shares of the demographic, diagnostic and hospitalization variables involved in all acute admissions registered in a catchment area in Brazil between 1998 and 2004. Results: From the 11,208 admissions, 47.8% of the patients were admitted to a psychiatric hospital and 14.1% to a general hospital. The emergency psychiatry unit accounted for 38.1% of all admissions during the period, with a higher variability in occupancy rate and bed turnover during the years. Around 80% of the hospital stays lasted less than 20 days and in almost half of these cases, patients were discharged in 2 days. Although the total number of admissions remained stable during the years, in 2004, a 30% increase was seen compared to 2003. In 2004, bed turnover and occupancy rate at the emergency psychiatry unit increased. Conclusion:The increase in the number of psychiatric admissions in 2004 could be attributed to a lack of new community-based services available in the area beginning in 1998. Changes in the health care network did affect the emergency psychiatric service and the limitations of the community-based network could influence the rate of psychiatric admissions. Descriptors

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“…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%

“…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: 99%

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

Segal¹,

Akutsu²,

Watson³

1998

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Psychiatric Emergency Services in a Canadian City: I. Prevalence and Patterns of Use

Cited by 71 publications

References 7 publications

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

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

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

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

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