title: Association between mental health apprehensions by police and monthly income assistance (welfare) payments.
abstract: OBJECTIVE
  Social misconduct, increased police activity, and increased emergency department (ED) use are associated with monthly income assistance (welfare) payments. The relation, if any, between welfare payments and mental health and addictions presentations to the ED requiring police involvement remains unknown. Our purpose was to determine if a relation exists between mental health apprehensions (MHAs) by police and monthly welfare cheque distribution, and the association between monthly payments and mental health and substance-related ED presentations.
  
  
  METHODS
  The Vancouver Police administrative database was analyzed during an 81-week period (June 8, 2011, to December 25, 2012). Comparisons were made between the numbers of MHAs by police during the week following welfare payment to those during nonpayment weeks. The weekly number of mental health and substance-related ED presentations were also analyzed during the study period. MHAs were analyzed continuously, and compared using the 2-tailed t test.
  
  
  RESULTS
  During the study period, 4009 MHAs occurred (range 1 to 18 MHAs/day). The mean weekly MHAs during welfare week was 54.6 (95% CI 51.75 to 57.45), compared with 48.6 (95% CI 46.35 to 50.85) during nonpayment weeks (P = 0.004). This translates to 85 MHAs annually related to welfare payments. Total mental health and addictions-related presentations to the ED were also significantly increased in the week following welfare payments (P < 0.001), and could not be solely attributed to increased MHAs by police.
  
  
  CONCLUSIONS
  A statistically significant increase in the number of MHAs by police follows welfare payments. This is superimposed on a significant increase in overall mental health and substance-related ED presentations seen during the same period.
authors.affiliation: Attending Physician, Emergency Department, St Paul's Hospital, Vancouver, British Columbia; Clinical Associate Professor, Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia; Graduate Student, Department of Forensic Medicine, Monash University, Melbourne, Australia.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Pickett
authors.affiliation: Attending Physician and Research Director, Emergency Department, St Paul's Hospital, Vancouver, British Columbia; Assistant Professor, Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stenstrom
authors.affiliation: Attending Physician, Emergency Department, Vancouver General Hospital, Vancouver, British Columbia; Associate Professor and Research Director, Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia.
authors.forename: Riyad B
authors.initials: RB
authors.lastname: Abu-Laban
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology*; D016495:Police / Q000706:statistics & numerical data*; D012946:Social Welfare / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data