More Than Suicide: Mortality After Emergency Psychiatric Care and Implications for Practice

Simpson, Scott A.; Shy, Bradley D.; Loh, Ryan

doi:10.1016/j.jaclp.2021.12.009

Journal of the Academy of Consultation-Liaison Psychiatry

2022

DOI: 10.1016/j.jaclp.2021.12.009

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More Than Suicide: Mortality After Emergency Psychiatric Care and Implications for Practice

Scott A. Simpson

Bradley D. Shy

Ryan Loh

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Cited by 5 publications

(3 citation statements)

References 39 publications

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“…7 Although suicide appropriately remains among the most important targets for patient safety activities within psychiatry, 8 patients who receive psychiatric care are not immune to other kinds of adverse events. A recently published study by Simpson et al 9 found that the majority of patients who died after seeking care in a psychiatric emergency service in fact died from causes other than suicide, although suicide death was still more common among this group compared to those who had sought care in a general emergency department.…”

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confidence: 97%

Anticipating Patient Safety Events in Psychiatric Care

YERSTEIN,

SUNDARARAJ,

MCLEAN

et al. 2024

Journal of Psychiatric Practice

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Objectives: Although suicide prevention often dominates patient safety efforts in psychiatry and behavioral health, patients who seek such services are also prone to other kinds of adverse events. The purpose of this study was to more fully characterize the types of safety events that occur in the context of psychiatric care. Methods: This was a retrospective study of safety events that had been reported to a hospital-based psychiatry department during a 4-year period. The authors reviewed each incident, developed new and more precise event categories, and assigned each report to a category. Events that could not be categorized were assigned to an “Other” category. The percentages of categorizable events between the new and old frameworks were compared. Results: A total of 366 reports were filed. In the updated framework, 324 events (89%) could be categorized compared to 225 (61%) in the original registry. Conclusions: Understanding the kinds of safety events that clinicians are likely to encounter in the context of psychiatric care may help to expand patient safety efforts beyond suicide risk prevention.

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confidence: 97%

Anticipating Patient Safety Events in Psychiatric Care

YERSTEIN,

SUNDARARAJ,

MCLEAN

et al. 2024

Journal of Psychiatric Practice

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“…Methamphetamine use disorder is correlated with high rates of psychosis, mood symptoms, suicidality, and ongoing ED utilization 7–9 . A methamphetamine use diagnosis is also associated with higher mortality after ED discharge 10 …”

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confidence: 99%

“…[7][8][9] A methamphetamine use diagnosis is also associated with higher mortality after ED discharge. 10 Methamphetamine-induced psychosis (MIP) is a consequence of methamphetamine use in which patients experience paranoid delusions, hallucinations, and thought process disorganization beyond the initial period of intoxication. MIP occurs in up to 40% of methamphetamine users, can last for months after use, harbors unique challenges for treatment, and portends worse outcomes.…”

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confidence: 99%

Evaluation of the BEAT Meth Intervention for Emergency Department Patients with Methamphetamine Psychosis

et al. 2022

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ObjectivesMethamphetamine is the second leading cause of overdose death in America and a leading cause of emergency department (ED) visits. Methamphetamine-induced psychosis is a dangerous and difficult-to-treat consequence of methamphetamine use. We describe the pilot implementation and outcomes of a multimodal treatment intervention for ED patients with methamphetamine psychosis, Beginning Early and Assertive Treatment for Methamphetamine Psychosis (BEAT Meth).MethodsBEAT Meth was implemented in an urban safety net health system. The protocol includes early identification and treatment of methamphetamine psychosis, a protocolized hospitalization, and support for transitioning patients to specialty addiction treatment. Patients receiving BEAT Meth were compared with ED patients with methamphetamine psychosis who were discharged. Implementation fidelity was measured to assess feasibility.ResultsBEAT Meth patients were nearly 3 times more likely to attend an outpatient specialty addiction appointment in the 30 days after discharge than comparison patients (32% vs 11%, P < 0.01). Subsequent ED utilization was common among all patients, and there was no significant difference in 30-day ED return rates between BEAT Meth and comparison patients (28% vs 37%, P = 0.10). Exploratory analyses suggested that increased attendance at outpatient treatment reduced ED utilization.ConclusionsBEAT Meth is an intervention framework to support identification, management, and treatment engagement of ED patients with methamphetamine psychosis. Treatment strategies like BEAT Meth are necessary to manage the unique challenges of methamphetamine addiction. These findings will guide clinical care, program development, and research.

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Use of an Agitation Measure to Screen for Suicide and Self-Harm Risk Among Emergency Department Patients

Simpson

Goans

Loh

et al. 2023

Journal of the Academy of Consultation-Liaison Psychiatry

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More Than Suicide: Mortality After Emergency Psychiatric Care and Implications for Practice

Cited by 5 publications

References 39 publications

Anticipating Patient Safety Events in Psychiatric Care

Anticipating Patient Safety Events in Psychiatric Care

Evaluation of the BEAT Meth Intervention for Emergency Department Patients with Methamphetamine Psychosis

Use of an Agitation Measure to Screen for Suicide and Self-Harm Risk Among Emergency Department Patients

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