Why Do Patients Seek Emergency Psychiatric Care? Their Reasons and Characteristics
We reviewed 200 consecutive evaluations in a teaching hospital emergency department via chart review. Data collected included psychiatric history, substance use, and contributing etiologies. PES clinicians involved were asked directly about underlying reasons for emergent care and whether suitable care could have been provided in a less acute setting.
Acute behavioral disturbances proved to be the most frequent reason for emergency visits. Half of all visits were because of uncontrollable, potentially uncontrollable, or unacceptable behavior. Direct provider referrals accounted for 31% of visits. Inability to cope with life events accounted for another 6%. Traditional psychiatric illness was a contributing factor in most visits (67.5%); other significant factors were relationship problems (20%) and substance abuse (16.5%). Alternative facilities could have taken care of 26% of visits.
We found that the vast majority of emergent psychiatric visits warranted immediate attention; only a minority (13%) of visits were not urgent. Patients who did not require emergency care could have been served by walk-in clinics, drug detoxification facilities, or faster access to outpatient treatment.
Advisor:Seth M. Powsner
School Location:USA - Connecticut
Source Type:Master's Thesis
Keywords:emergency service hospital substance related disorders utilization mental services psychiatric
Date of Publication:09/08/2008