Management of mental health patients attending Victorian emergency departments.
OBJECTIVE
To evaluate the management of mental health presentations to Victorian emergency departments.


METHODS
An observational study in five Victorian emergency departments (four metropolitan and one regional). All patients with an ICD-10 discharge diagnosis for a predetermined mental health disorder were included. Data were collected on patient demographics, presentation, clinical management (emergency and mental health) and disposition.


RESULTS
There were 3702 patients enrolled (96.0% of all mental health presentations). At presentation 39.1% were intoxicated and 39.9% arrived by ambulance, 17.6% with the police. There was a significant variation (p <0.001) between sites for: the median time to be seen by a clinician (14 vs 43 min), the time between referral to and review by mental health services (15 vs 50 min), the median time in the emergency department (208 min vs 380 min), the proportion who spent >24 h in the emergency department (0.0% vs 11.6%) and disposition (proportion discharged home from ED 49.8% vs 63.5%).


CONCLUSIONS
Important variations were identified in the management of patients with mental health presentations to Victorian emergency departments. This variation is most likely due to differing access to resources. All levels of administration must work with carers and patients to ensure that optimal patient care is provided at every site.
Emergency Medicine Research Unit, Royal Melbourne Hospital, Parkville, Australia. jonathan.knott@mh.org.au
Jonathan C
JC
Knott
Alex
A
Pleban
David
D
Taylor
David
D
Castle
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D003419:Crisis Intervention / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013996:Time and Motion Studies; D014600:Utilization Review / Q000706:statistics & numerical data; D014739:Victoria