title: Use of a mental health emergency care-rural access programme in emergency departments.
abstract: Hospital emergency departments (EDs) are common providers of emergency mental health care. Access to specialist expertise can affect and improve patient outcomes. The Mental Health Emergency Care-Rural Access Programme (MHEC) provides access to mental health specialists for rural and remote communities in western New South Wales. In 2011, 46 of the 48 EDs used the MHEC programme, which provided 1487 clinical services, an average of 29 services per week. This represented 60% of all MHEC activity. A video assessment was conducted during 571 (38%) of these MHEC contacts. Patients attending a non-base hospital (<50 beds) were twice as likely to receive a video assessment as those attending the larger base hospitals, and video was used more with increasing remoteness. Patients from non-base hospitals were also more likely to be admitted locally after a video assessment. When a decision to admit was made, patients from non-base hospital EDs assessed by video were less likely to be transferred out of their community to a mental health inpatient unit than those assessed by telephone triage only (46% vs 62%; P = 0.016). The MHEC programme is a practical, relevant and responsive solution that was designed for the Australian health system, but the same model could be adapted for implementation in other countries.
authors: University Department of Rural Health, University of Sydney - Broken Hill, Broken Hill, New South Wales, Australia emily.saurman@sydney.edu.au.
authors: Emily
authors: E
authors: Saurman
authors: University Department of Rural Health, University of Sydney - Broken Hill, Broken Hill, New South Wales, Australia.
authors: David
authors: D
authors: Lyle
authors: University Department of Rural Health, University of Sydney - Broken Hill, Broken Hill, New South Wales, Australia.
authors: Sue
authors: S
authors: Kirby
authors: University of Sydney, Orange, New South Wales, Australia.
authors: Russell
authors: R
authors: Roberts
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis*; D008605:Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D009517:New South Wales; D015397:Program Evaluation; D019114:Remote Consultation / Q000379:methods* / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D014741:Video Recording