The suburban-city divide: an evaluation of emergency department mental health presentations across two centres

McLoughlin, Caoimhe; McLoughlin, Aiden J.; Jain, Sudha; Abdalla, Ahad; Cooney, John; MacHale, Siobhan

doi:10.1007/s11845-020-02496-w

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…The possible mechanisms may be through differential healthcare service access, social needs, transportation connectedness, or neighborhood environment. 14,40,41 For example, living in the suburbs usually requires longer house-to-job distances, which has been found to be associated with poorer mental health. 40 The longer job commutes implied more need for transportation facilities, and, similar to our linear elastic net regression model, the higher percentage of infrastructure land use was related to less depressive symptoms in Cluster 1 (suburban).…”

Section: Discussionmentioning

confidence: 99%

Exposome approaches to assessing the association between urban land use environment and depressive symptoms in young adulthood: a FinnTwin12 cohort study

Wang

Whipp

Heinonen-Guzejev

et al. 2023

Preprint

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Background: Depressive symptoms lead to a serious public health burden and are considerably affected by the environment. Land use, describing the urban living environment, has an impact on mental health, but complex relationship assessment is rare. Objectives: We aimed to examine the complicated association between urban land use and depressive symptoms among young adults with differential land use environments, by applying multiple models, as an exposome study. Methods: We included 1804 individual twins from the FinnTwin12 cohort, living in urban areas in 2012. There were 8 types of land use exposures in 3 buffer radii. The depressive symptoms were assessed through General Behavior Inventory (GBI) in young adulthood (mean age: 24.1). First, K-means clustering was performed to distinguish participants with differential land use environments. Then, linear elastic net penalized regression and eXtreme Gradient Boosting (XGBoost) were used to reduce dimensions or prioritize for importance and examine the linear and nonlinear relationships. Results: Two clusters were identified with notable differences in the percentage of high-density residential, low-density residential, and natural land use. One is more typical of city centers, and another of suburban areas. A heterogeneous pattern in results was detected from the linear elastic net penalized regression model among the overall sample and the two separated clusters. Agricultural residential land use in a 100 m buffer contributed to GBI most (coefficient: 0.097) in the "suburban" cluster among 11 selected exposures. In the "city center" cluster, none of the land use exposures was associated with GBI. From the XGBoost models, we observed that ranks of the importance of land use exposures on GBI and their nonlinear relationships are also heterogeneous in the two clusters. Discussion: As a hypothesis-generating study, we found heterogeneous linear and nonlinear relationships between urban land use environment and depressive symptoms under different contexts in pluralistic exposome analyses.

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Section: Discussionmentioning

confidence: 99%

Exposome approaches to assessing the association between urban land use environment and depressive symptoms in young adulthood: a FinnTwin12 cohort study

Wang

Whipp

Heinonen-Guzejev

et al. 2023

Preprint

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“…This may be particularly important in the mental health sector. Many mental health emergency presentations pertain to individuals who have unmet social and addiction needs; 30 thus, having a complete picture of where local services need to target early intervention efforts is warranted.…”

Section: Discussionmentioning

confidence: 99%

Mental health emergency presentations across the Barwon South West region in Victoria, Australia: An epidemiological investigation

Kavanagh

Holloway‐Kew

Baker

et al. 2023

Emerg Medicine Australasia

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ObjectiveTo examine mental health emergency presentations across the Barwon South West, Victoria, Australia – an area comprising a range of urban and rural localities.MethodsThis is a retrospective synthesis of mental health emergency presentations across the Barwon South West (1 February 2017–31 December 2019). De‐identified data were obtained from individuals who presented to EDs and urgent care centres (UCCs) within the study region, who had a principal diagnosis of a Mental and Behavioural Disorder (codes F00‐F99). Data were sourced from the Victorian Emergency Minimum Dataset and Rural Acute Hospital Database Register (RAHDaR). Age‐standardised incident rates for mental health emergency presentations were calculated for the whole sample and for local government areas. Data on usual accommodation, arrival transport mode, referral source, patient disposition and length of ED/UCC stay were also obtained.ResultsWe identified 11 613 mental health emergency presentations, with neurotic, stress‐related and somatoform disorders (n = 3139, 27.0%) and mental and behavioural disorders due to psychoactive substance use (n = 3487, 30.0%) being the most frequent types of presentations recorded. The highest age‐standardised incidence rates (mental health diagnosis per 1000 population/year) were in Glenelg (13.95), whereas Queenscliffe had the lowest incident rates (3.76). Most presentations (n = 3851, 33.2%) tended to occur for individuals aged between 15 and 29 years.ConclusionsNeurotic, stress‐related and somatoform disorders and mental and behavioural disorders due to psychoactive substance use were the most frequent types of presentations recorded across the sample. RAHDaR represented a small but meaningful contribution to the data.

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“…The provision of these is idiosyncratic and there is no national standard. Where hospitals have data and information systems in place it allows for a more granular examination of the work of the CLP service ( 27 , 28 ). Universal information systems would allow comparisons to be made to similar work conducted internationally, and to establish whether the work of Irish CLP differs from other countries, and where it needs to be improved ( 25 , 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study

et al. 2021

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Objective: This study aimed to describe the provision of consultation-liaison psychiatry (CLP, also known as liaison psychiatry) services in acute hospitals in Ireland, and to measure it against recommended resourcing levels.Methods: This is a survey of all acute hospitals in Ireland with Emergency Departments, via an electronic survey sent by email and followed up by telephone calls for missing data. Data were collected on service configuration, activity, and resourcing. Data were collected from CLP or proxy services at all acute hospitals with an Emergency Department in Ireland (n = 29). This study measured staffing and activity levels where available.Results: None of the services met the minimum criteria set out by either national or international guidance per 500 bed general hospital.Conclusions: CLP is a relatively new specialty in Ireland, but there are clear international guidelines about the staffing levels required to run these services safely and effectively. In Ireland, despite clear national guidance on staffing levels, no services are staffed to the levels suggested as the minimum. It is likely that patients in Ireland's acute hospitals have worse outcomes, and hospitals have unnecessary costs, due to this lack. This is the first study of CLP provision in Ireland and demonstrates the resource constraints under which most services work and the heterogeneity of services nationally.

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The suburban-city divide: an evaluation of emergency department mental health presentations across two centres

Cited by 5 publications

References 25 publications

Exposome approaches to assessing the association between urban land use environment and depressive symptoms in young adulthood: a FinnTwin12 cohort study

Exposome approaches to assessing the association between urban land use environment and depressive symptoms in young adulthood: a FinnTwin12 cohort study

Mental health emergency presentations across the Barwon South West region in Victoria, Australia: An epidemiological investigation

Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study

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