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

Abstract

The qualitative and quantitative findings are congruent with other studies supporting the use of properly implemented mental health triage and crisis counsellors to improve the care of persons with mental health concerns.

The Care of Mental Health Patients in the Emergency Department: One Rural Hospital's Approach

“…Some hospitals have added mental health services in their EDs. In one hospital, the use of a mental health triage and crisis counselor decreased waits for mental health patients and improved post-intervention success (4). The problem in our hospital was typical of many US hospitals, with a steady increase in the number of patients accessing ED services (including mental health patients) and long waits for patients needing mental health services.…”

Strength-based crisis programming: Evaluating the process of care

“…Moreover, a circle of care can provide support and alternative resources to access when attempting to resolve future crises. As well, the research literature on crisis intervention programs has also found that connecting service users to external agencies and professionals (Dion et al, 2010;Krupa et al, 2010;Malla, Norman, McLean, Scholten, & Townsend, 2003;Vingilis et al, 2007), can support the attainment of independent community living, as depicted in the Outcome component of the conceptual model.…”

A Systematic Review of Crisis Interventions Used in the Emergency Department

“…34 The CTAS has been investigated via an educational program in a study, 26 which could be translated into the pediatric setting. The ability to extrapolate findings to pediatrics may not hold true for the 2 Australian Mental Health Triage Scales, 28Y31 which were developed for a defined geographical area, or the population health triage scale, 25 which addresses issues potentially less relevant in pediatric mental health than in adults. More discussion and evaluation may be needed before these triage tools are ready for pediatric application and evaluation.…”

“…24Y26,28Y31 Five of these 6 studies investigated approaches to patient triage. 25,26,28Y31 Length of stay, 25,26,31 triage category, 26,28Y30 confidence, 30 disposition, and follow-up characteristics 25,26 were measured. The sixth study examined the impact of a computerized reminder system on restraint order renewal.…”

“…An increase in patients who left without being seen was reported after implementation of the educational session (OR, 2.41; 95% CI, 0.81Y8.04); however, differences in left-withoutbeing-seen classification between mental health and medical ED staff make interpretation of this finding difficult. 26 25 ; however, missing sample size data make interpretations difficult.…”