Trends in U.S. Emergency Department Visits for Mental Health Conditions, 1992 to 2001

Larkin, Gregory Luke; Claassen, Cynthia A.; Emond, Jennifer A.; Pelletier, Andrea J.; Camargo, Carlos A.

doi:10.1176/appi.ps.56.6.671

Cited by 288 publications

(171 citation statements)

References 32 publications

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“…4 From 1992 to 2001, in the United States, there was a substantial increase in the number of visits to emergency units due to psychiatric conditions (from 17.1 to 23.6 per 1000 inhabitants). 5 In Brazil, particularly since the changes to mental health policies that began in the mid-1980s, 6 care for patients with mental disorders has started to be based on outpatient services and PES have taken a prominent role in the care network. 7 PES have an important role in indicating the treatment for each case, playing a role in screening new cases, placing patients in the available service network, assessing and treating acute behavioral changes and associated medical conditions, and providing help in hospitalizations, especially in non-operating periods at other services.…”

Section: Introductionmentioning

confidence: 99%

Profile of patients attended as psychiatric emergencies at a university general hospital

et al. 2013

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CONTEXT AND OBJECTIVE: The prevalence of psychiatric conditions in clinical settings is high, particularly in emergency services. This is a challenge for healthcare professionals and an essential element in the functioning of the mental health network. The objective here was to describe the sociodemographic and clinical profile and the practices among patients treated psychiatrically in the Emergency Unit. DESIGN AND SETTING: Descriptive and quantitative study, conducted at Hospital das Clínicas (HC), Universidade Estadual de Campinas (Unicamp). METHODS: Sociodemographic data, reasons for attendance, diagnostic hypotheses and practices were analyzed. RESULTS: Psychiatric staff attended 1,835 cases over the study period, corresponding to 1465 patients. The patients were predominantly women (53.7%) and white (79.6%); their mean age was 37 years and 41.3% lived with their parents. The commonest reasons for attendance were depressive symptoms (28.1%), agitation (23.6%) and problems with psychoactive substances (19.5%). The commonest diagnoses were psychoactive substance-related disorders (23%) and depressive disorders (18.5%). 31.6% of the patients were referred to healthcare centers and 29.2% to specialized outpatient clinics, while 8.2% were hospitalized. CONCLUSIONS: This study emphasizes that it is important for professionals working in emergency service to have information about the patients' profile and the main reasons that lead them to seek psychiatric care, and to establish a diagnosis that will allow proper management at the emergency service and case referral. RESUMO CONTEXTO E OBJETIVO:A prevalência de quadros psiquiátricos em contextos clínicos é elevada, particularmente em serviços de emergência, representando um desafio para os profissionais da saúde e um elemento essencial no funcionamento da rede de saúde mental. Objetivou-se descrever o perfil sócio-demográfico, clínico e condutas para pacientes atendidos pela psiquiatria na Unidade de Emergência.

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Section: Introductionmentioning

confidence: 99%

Profile of patients attended as psychiatric emergencies at a university general hospital

et al. 2013

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“…1 While prior studies have suggested a similar trend in pediatric psychiatric ED visits, the most recent study that analyzed national trends using national estimates used data concluding in 2001. 2 A more recent study by Mahajan et al, 3 from the Pediatric Emergency Care Applied Research Network (PECARN) set forth to investigate which demographic factors may be associated with higher rates of ED psychiatric visits.…”

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confidence: 99%

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

Pittsenbarger

Mannix

2013

Academic Emergency Medicine

125

106

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Objectives: While recent studies have demonstrated an overall increase in psychiatric visits in the emergency department (ED), none have focused on a nationally representative pediatric population. Understanding trends in pediatric psychiatric ED visits is important because of limited outpatient availability of pediatric specialists, as well as long wait times for psychiatric appointments. The study aim was to evaluate the trends in ED psychiatric visits for children between 2001 and 2010 with comparison by sociodemographic characteristics.Methods: This was a retrospective, cross-sectional analysis of ED psychiatric visits for children < 18 years of age using the National Hospital Ambulatory Medical Care Survey (NHAMCS). Visits were identified by International Classification of Diseases, Ninth Revision (ICD-9), codes. Outcome measures included frequency of visits for children with psychiatric diagnosis codes and odds and adjusted odds of psychiatric visits controlling for temporal, demographic, and geographic factors.

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“…Problems related to the use of psychoactive substances, including intoxication and withdrawal episodes, which are commonly associated with agitated and/or violent behavior, are among the main causes presenting in emergency services and requiring psychiatric care. 1,5 Similarly, agitated, potentially aggressive, and openly violent behaviors are not particular to any specific mental disorder and also imply the necessity for a broad investigation to perform the differential diagnosis. Patients with severe psychiatric disorders, particularly schizophrenia and manic episodes, use general and psychiatric emergency services more often than the general population.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…In the United States, 5% of emergency admissions are estimated to be related to behavioral disturbances. 1 In a significant portion of cases, admissions are motivated by agitation and/or aggressiveness. In Brazil, emergency admissions due to mental disorders account for approximately 3% of the total admissions in general hospital emergency services, 2 with one-fourth of these admissions being due to agitated or violent behavior.…”

Section: Introductionmentioning

confidence: 99%

Manejo de paciente agitado ou agressivo

Mantovani

Migon

Alheira

et al. 2010

Rev. Bras. Psiquiatr.

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Objective: To review current data concerning the management of agitated or aggressive patients. Method: A search was performed in the PubMed and Web of Science databases and empirical articles and reviews about pharmacological and non-pharmacological interventions for the management of agitation and/or violence were selected and analyzed. Results: The non-pharmacological management of agitation/aggression involves the physical organization of the emergency department and the adequacy of the behavior and attitudes of health professionals. The main goal of pharmacological management is rapid tranquilization, aimed at reducing symptoms of agitation and aggression without inducing deep or prolonged sedation, keeping the patient calm but fully or partially responsive. Polypharmacy should be avoided and medication doses should be as low as possible, adjusted according to clinical requirements. Intramuscular administration of drugs should be considered as a last option. Available options related to the use of antipsychotics and benzodiazepines are described and discussed. The physical management by means of mechanical restraint may be necessary in violent situations involving risks for the patient or staff and must be performed according to strict criteria. Conclusion: Procedures must be carefully implemented to avoid physical and emotional complications for patients and staff. Descriptors

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Trends in U.S. Emergency Department Visits for Mental Health Conditions, 1992 to 2001

Abstract: Mental health-related visits constitute a significant and increasing burden of care in U.S. emergency departments.

Cited by 288 publications

References 32 publications

Profile of patients attended as psychiatric emergencies at a university general hospital

Profile of patients attended as psychiatric emergencies at a university general hospital

Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses

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