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Changing demand for mental health services in the emergency department of a public hospital.
Aust N Z J Psychiatry. 2005 Jan-Feb; 39(1-2):74-80.AN

Abstract

OBJECTIVE

Deinstitutionalization and mainstreaming may have contributed to increased attendance in public emergency departments by people with mental health problems. This study describes changing patterns of attendances by patients with mental health problems to the emergency department (ED) of a public teaching hospital in Adelaide, South Australia.

METHOD

Records from a 10-year period from the ED were examined to identify changes in the number of, and diagnoses for, patients attending for primarily mental health concerns. Admission rates, detention and length of stay (LOS) were also examined in an attempt to identify trends.

RESULTS

A tenfold increase in the number of patients attending the ED with primarily mental health problems has occurred over the 10-year period. This is within the context of relatively stable total ED presentations. The increase has been observed in all diagnostic categories although the greatest increase, by percentage, has been for psychotic disorders. A lesser increase was observed for patients presenting with overdose. People presenting with psychotic disorders are also more likely to be detained and admitted. LOS in the ED has also increased along with increasing demand.

CONCLUSIONS

Reasons for the increased demand are likely multifactorial. While deinstitutionalization and mainstreaming have contributed, the closure of the ED at the local psychiatric hospital does not account entirely for the change. Insufficient community-based mental health services may also contribute to the reasons why people present to the ED and lack of inpatient beds contributes to the increasing LOS experienced in the ED.

Authors+Show Affiliations

Department of Psychiatry, Flinders Medical Centre, Bedford Park, South Australia, Australia. ross.kalucy@fmc.sa.gov.auNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15660708

Citation

Kalucy, Ross, et al. "Changing Demand for Mental Health Services in the Emergency Department of a Public Hospital." The Australian and New Zealand Journal of Psychiatry, vol. 39, no. 1-2, 2005, pp. 74-80.
Kalucy R, Thomas L, King D. Changing demand for mental health services in the emergency department of a public hospital. Aust N Z J Psychiatry. 2005;39(1-2):74-80.
Kalucy, R., Thomas, L., & King, D. (2005). Changing demand for mental health services in the emergency department of a public hospital. The Australian and New Zealand Journal of Psychiatry, 39(1-2), 74-80.
Kalucy R, Thomas L, King D. Changing Demand for Mental Health Services in the Emergency Department of a Public Hospital. Aust N Z J Psychiatry. 2005 Jan-Feb;39(1-2):74-80. PubMed PMID: 15660708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing demand for mental health services in the emergency department of a public hospital. AU - Kalucy,Ross, AU - Thomas,Lyndall, AU - King,Diane, PY - 2005/1/22/pubmed PY - 2005/6/29/medline PY - 2005/1/22/entrez SP - 74 EP - 80 JF - The Australian and New Zealand journal of psychiatry JO - Aust N Z J Psychiatry VL - 39 IS - 1-2 N2 - OBJECTIVE: Deinstitutionalization and mainstreaming may have contributed to increased attendance in public emergency departments by people with mental health problems. This study describes changing patterns of attendances by patients with mental health problems to the emergency department (ED) of a public teaching hospital in Adelaide, South Australia. METHOD: Records from a 10-year period from the ED were examined to identify changes in the number of, and diagnoses for, patients attending for primarily mental health concerns. Admission rates, detention and length of stay (LOS) were also examined in an attempt to identify trends. RESULTS: A tenfold increase in the number of patients attending the ED with primarily mental health problems has occurred over the 10-year period. This is within the context of relatively stable total ED presentations. The increase has been observed in all diagnostic categories although the greatest increase, by percentage, has been for psychotic disorders. A lesser increase was observed for patients presenting with overdose. People presenting with psychotic disorders are also more likely to be detained and admitted. LOS in the ED has also increased along with increasing demand. CONCLUSIONS: Reasons for the increased demand are likely multifactorial. While deinstitutionalization and mainstreaming have contributed, the closure of the ED at the local psychiatric hospital does not account entirely for the change. Insufficient community-based mental health services may also contribute to the reasons why people present to the ED and lack of inpatient beds contributes to the increasing LOS experienced in the ED. SN - 0004-8674 UR - https://www.unboundmedicine.com/medline/citation/15660708/Changing_demand_for_mental_health_services_in_the_emergency_department_of_a_public_hospital_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0004-8674&date=2005&volume=39&issue=1-2&spage=74 DB - PRIME DP - Unbound Medicine ER -