title: Frequent visitors to psychiatric emergency services: staff attitudes and temporal patterns.
abstract: Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Center for Healthcare Effectiveness Research, Wayne State University School of Medicine, 2761 E. Jefferson, Detroit, MI 48207, USA. carfken@med.wayne.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Arfken
authors.forename: Lori Lackman
authors.initials: LL
authors.lastname: Zeman
authors.forename: Lindsay
authors.initials: L
authors.lastname: Yeager
authors.forename: Edward
authors.initials: E
authors.lastname: Mischel
authors.forename: Alireza
authors.initials: A
authors.lastname: Amirsadri
mesh_terms: D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006302:Health Services Research; D006786:Hospitals, Urban; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012621:Seasons; D013995:Time; D035862:Vulnerable Populations; D014887:Weather