Demographic and Clinical Profiles of Patients Who Make Multiple Visits to Psychiatric Emergency Services

Chaput, Yves; Lebel, Marie-Josée

doi:10.1176/ps.2007.58.3.335

Cited by 92 publications

(41 citation statements)

References 36 publications

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“…However, this is consistent with findings in most previous studies on the behavioral model's ability to predict service use [12,13]. In addition, the study did not include the full spectrum of psychiatric disorders such as schizophrenia which may account for a greater utilization of resources, especially specialized care [26].…”

Section: Discussionsupporting

confidence: 87%

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

et al. 2011

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The study aims to compare variables associated with the exclusive and joint use of primary and specialized care for mental health reasons by individuals diagnosed with a mental disorder in a Montreal/Canadian catchment area. Data were collected from a random sample (2,443 individuals). Among 406 people, diagnosed with a mental disorder 12 months pre-interview, 212 (52%) reported having used healthcare services. Compared to users of primary care only, people who sought both primary and specialized care presented more mental disorders and lower quality of life. People using only specialized healthcare received significantly less social support than persons using primary care exclusively and lived in neighborhoods with a high proportion of rental housing. Healthcare service provision should favor social networking and enable social cohesion and integration, particularly in neighborhoods with a high proportion of rental housing. Shared care and enhanced collaboration with other public and community-based resources should be encouraged.

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Section: Discussionsupporting

confidence: 87%

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

et al. 2011

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“…These findings are similar to those of Pasic et al 5 We also found that frequent attenders had longer psychiatric histories, higher rates of schizophrenia, and were more likely to be prescribed antipsychotics, but had equal gender distribution as compared with single attenders. Chaput & Lebel 6 reported similar findings in their study of similar patient population.…”

Section: Discussionsupporting

confidence: 69%

“…3 Well-developed community-oriented strategies, such as modified intensive case management and outreach programmes, which have been shown to reduce the heavy use of psychiatric in-patient services, 8 could also help limit frequent attenders' visits by reducing social instability and increasing treatment adherence. 6 …”

Section: Discussionmentioning

confidence: 99%

Patients repeatedly attending accident and emergency departments seeking psychiatric care

2011

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Attendance at accident and emergency (A&E) departments by patients seeking psychiatric care is quite common as A&E departments usually provide crisis intervention as well as serve as an entry point for hospital admission. 1,2 However, some patients repeatedly attend A&E seeking assessment and psychiatric care. These patients may have unmet mental health needs that require more service input. Identifying the clinical characteristics of this patient group and targeting them with more suitable care strategies may reduce such frequent visits to the A&E department.Individuals who frequently attend A&E for psychiatric care have been characterised by other studies 3,4 as being younger males, of Black and minority ethnic background, unmarried, unemployed, and being more likely to have diagnoses of personality disorders and substance misuse. The aim of our study was to identify the clinical characteristics of patients who frequently attend for emergency psychiatric assessment and treatment at the A&E department of the University College Hospital in Galway, Ireland. Emergency psychiatric care at the hospital is shared between a psychiatric emergency liaison team and the out-of-hour duty psychiatric doctors. Ongoing care is provided in the community or acute psychiatric unit by various multidisciplinary teams. We identified patients who received emergency psychiatric care in the A&E department three or more times in a 6-month period and compared their demographic and clinical characteristics with those who received such care only once in the same period. We also examined the relationships between frequent A&E attendance for psychiatric care and hospital admission. MethodAll patients who presented to the A&E department seeking emergency psychiatric care from 1 July to 31 December 2007 were identified. The number of times each patient had attended over that period was tabulated and those who attended frequently were identified.Frequent attenders were defined as those patients who presented for psychiatric care three or more times, whereas single attenders accessed psychiatric care only once within this 6-month period. The threshold of three visits was selected as being likely to represent a subgroup of patients with higher than average visiting profile. Three or more visits were in excess of the 95th percentile for attendances to the A&E department for psychiatric care.Each frequent attender was compared with three randomly selected single attenders matched by age (5-year age bands) and gender. Random selection of the single attenders was based on computer-generated random numbers. In all, 26 frequent attenders were identified; however, data were available for only 24 of them (92.3%). These were then matched with 72 single attenders. The psychiatric records of the 96 individuals were then examined. The information collected for each patient included: Aims and method This study was conducted to ascertain the clinical characteristics of patients who repeatedly attend accident and emergency (A&E) department seeking psychiatric ...

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“…Overcrowding in emergency departments (EDs) has become an issue of increasing concern in many jurisdictions [1,2], with repeated visits to the ED contributing to this phenomenon [1,3,4]. Many studies have shown that a relatively small group of patients account for a disproportionate number of ED visits [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Examining the need profiles of patients with multiple emergency department visits for mental health reasons: a cross-sectional study

Sirotich

Durbin

2016

Soc Psychiatry Psychiatr Epidemiol

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The repeat ED user group within case management may have distinct need profiles that require different treatment responses. Moreover, clinical needs rather than psychosocial needs have the greatest relationship with repeat psychiatric ED utilization. These unmet needs suggest areas for future interventions aimed at reducing the use of ED services for mental health reasons and improving care for patients who repeatedly present at the ED.

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Demographic and Clinical Profiles of Patients Who Make Multiple Visits to Psychiatric Emergency Services

Abstract: Most visits to the psychiatric emergency service were made by frequent users who had distinctive profiles, which are potentially useful for developing clinical strategies to reduce the impact of this patient group on this service.

Cited by 92 publications

References 36 publications

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

Determinants Associated with the Utilization of Primary and Specialized Mental Health Services

Patients repeatedly attending accident and emergency departments seeking psychiatric care

Examining the need profiles of patients with multiple emergency department visits for mental health reasons: a cross-sectional study

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