title: Are mental health problems associated with use of Accident and Emergency and health-related harm?
abstract: BACKGROUND
  Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole.
  
  
  METHODS
  Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm.
  
  
  RESULTS
  Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures.
  
  
  CONCLUSIONS
  The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.
authors.affiliation: University of Reading, Reading, UK. j.keene@reading.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Keene
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D001523:Mental Disorders; D008875:Middle Aged; D016017:Odds Ratio; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000209:etiology*