title: Profiling frequent presenters to the emergency department for mental health complaints: socio-demographic, clinical, and service use characteristics.
abstract: BACKGROUND
  A small subset of individuals makes a disproportionate number of ED visits for mental health complaints.
  
  
  OBJECTIVE
  To explore the population profile and associated socio-demographic, clinical, and service use factors of individuals who make frequent visits (5+ annually) to hospital EDs for mental health complaints.
  
  
  METHODS
  Case-control study using electronic health record data.
  
  
  RESULTS
  Frequent presenters represented 3% of mental health ED patients and accounted for 18% of visits. Several factors were significantly associated with frequent ED use, including limited social support, documented personality disorder/traits, regular antipsychotic use, self-reported alcohol use, and having multiple referral sources.
authors.affiliation: School of Nursing, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: avandyk@uottawa.ca.
authors.forename: Amanda Digel
authors.initials: AD
authors.lastname: Vandyk
authors.affiliation: School Nursing and Dept of Anesthesiology & Perioperative Medicine; Practice and Research in Nursing Group, Queen's University, Kingston, Ontario. Electronic address: ev5@queensu.ca.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: VanDenKerkhof
authors.affiliation: University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Box 711, Ottawa, Ontario. Electronic address: igraha2@uottawa.ca.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Graham
authors.affiliation: Practice and Research in Nursing Group, Queen's University, Kingston, Ontario; Community Health and Epidemiology, Director Queen's Joanna Briggs Collaboration. Electronic address: Margaret.b.harrison@queensu.ca.
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Harrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D000069342:Medical Overuse / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000451:nursing* / Q000523:psychology; D008875:Middle Aged; D009864:Ontario; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents