Community psychiatric nursing intervention in an accident and emergency department: a clinical pilot study

Abstract

In a pilot study, 99 patients referred from a general hospital accident and emergency department were seen by a community psychiatric nurse (CPN) using a time series design. They were categorized into those patients having a previous psychiatric history and those with none. The level of service use for the 6 months immediately prior to CPN intervention, 6 months following referral, and 6 months of follow-up indicated a very high level of psychiatric and general medical service use by this group. Referral to the CPN was associated with substantial reduction in the demands on other services made by the group with previous psychiatric history. The group with no previous history showed a decrease in total service usage at follow-up.

A review of research on the structure, process and outcome of liaison mental health services

“…The number of psycho‐social referrals doubled, and the number of people with mental health problems re‐presenting at A & E reduced, following the introduction of a multidisciplinary liaison service in the UK (Morgan & Coleman 2000). The attachment of community psychiatric nurses to an A & E department was associated with an increase in clients’ use of mental health services and reduced the demands on other services (Storer et al . 1987).…”

Characteristics of an Accident and Emergency liaison mental health service in East London

“…Until the late 1980s in the United Kingdom (UK) there was little published literature on psychiatric liaison nursing (Roberts 1997). Work had already been reported in this field by Storer et al. (1987), who carried out a retrospective study of community psychiatric nurses (CPNs) attached to an Accident and Emergency (A & E) department.…”

“…Empirical evidence shows that A & E liaison mental health services reduce demands made on general health services by people with mental health problems (Storer et al. 1987).…”

“…1997, Roberts & Taylor 1997, Ryrie et al. 1997, Watts 1997, Puttman 1998, Reece 1998), others report some evaluation (Storer et al. 1987, McEvoy 1998).…”

Process and Outcome Evaluation of an Emergency Department Intervention for Persons with Mental Health Concerns Using a Population Health Approach

“…They found mean emergency waiting and transit times had reduced, more consistent mental health triage and admission rates by urgency had occurred, and customer satisfaction had improved with the use of the mental health triage. Storer, Whitworth, Salkovskis, and Atha (1987) examined the impact of referral of persons WMHC in ED to a community psychiatric nurse, with the associated outcome of a substantial decrease in demands on other services.…”