Predictors of Emergency Department Use for Suicidal Behaviors among Patients with Substance-Related Disorders

Fleury, Marie‐Josée; Grenier, Guy; Cao, Zhirong; Huỳnh, Christophe; Chihade, Dietta

doi:10.1080/13811118.2022.2066591

Cited by 2 publications

(2 citation statements)

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“…They were often referred to ED nonetheless, as outpatient services were deemed not responsive enough to deal with crisis situations, self-harm or overdoses. This aligns with existing literature, where ED have been identi ed as one of the primary resources for suicide prevention [48,11]. This study has found dissatisfaction with care to be a major structural barrier to outpatient care, one also conducive to high ED use.…”

Section: Discussionsupporting

confidence: 86%

“…Though several quantitative studies have assessed determinants of unmet needs for care among patients with MD [7,8], few have examined these unmet needs in relation to high ED use [6,9]. Some qualitative studies that explored high ED use among patients with MD found that unmet care needs partly explained high ED use [10][11][12]. Previous quantitative investigations have found that, compared to patients with MD who have few or no needs, patients with unmet care needs were more likely to be women, younger, and have severe MD symptoms, co-occurring MD-SRD or poor physical health conditions [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Barriers to Care among High Emergency Department Users with Mental Disorders – A Mixed Methods Study

Chen,

Fleury

2024

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Purpose The increasing number of high emergency department (ED) users is a growing concern worldwide. Patients with mental disorders (MD) are among the largest contributors to high ED use. As high ED use is often seen as an indicator of a healthcare system’s shortcomings, high ED users with MD may perceive unique barriers to care. Analyzing the associated patient characteristics and service use along with structural and motivational barriers to outpatient care use could help explain the high ED use among patients with MD, and help recommend more patient-centered interventions. Methods Data were extracted from a 2021–2022 survey and medical records of 182 high ED users with MD in four large ED networks from Quebec (Canada), including open-ended questions administered to 20 of these patients. A mixed methods approach (multivariable regression, thematic analysis) identified variables associated with the number of unmet care needs, and structural and motivational barriers to care explaining high ED use. Results The study partially confirmed its first hypothesis that patients with more health issues who were dissatisfied with services would have more barriers to care. The second hypothesis was also confirmed: structural barriers were more prevalent than motivational ones in relation to high ED use, and patients with high unmet needs had more care barriers than those with no unmet needs. Conclusions Findings suggest services could be greatly improved to reduce high ED use, and that unmet needs should be investigated further to better address the care barriers of this vulnerable population.

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Section: Discussionsupporting

confidence: 86%