title: Presentations by ambulance under the NSW Mental Health Act to an emergency department with a 24-hour mental health team.
abstract: OBJECTIVE
  The objective of this study was to examine the presentations of patients by ambulance, under Section 20 of the NSW Mental Health Act of 2007, to a hospital emergency department (ED) with a 24-hour Mental Health Team.
  
  
  METHODS
  Patient records between December 2013 and December 2014 were audited and analysed in Excel.
  
  
  RESULTS
  There were 47 such presentations: 51% required a mental health admission. Patients required management for up to six of the nine identified mental health and physical problems. As the number of clinical problems in these patients increased, the length of their stay and the likelihood of discharge to home increased. The need for psychiatric admission did not appear to prolong their length of stay, though chemical sedation did. The availability of an ED mental health team did assist in achieving a length of stay that was in keeping with Australian National Emergency Access Target guidelines.
  
  
  CONCLUSIONS
  A 24-hour ED mental health team provided specialised assessment and management for patients, alongside the necessary emergency medical intervention. This team assisted in easing the increasing pressure on the ED and minimising the patients' length of stay. The team redirected patients requiring admission, facilitated timely discharge of others and revoked Section 20 when less restrictive care was appropriate.
authors.affiliation: Consultant Psychiatrist and Visiting Medical Officer, Gosford Hospital Emergency Department Mental Health Team, Central Coast Local Health District, Gosford, NSW, Australia michaela.skopek@health.nsw.gov.au.
authors.forename: Michaela A
authors.initials: MA
authors.lastname: Skopek
authors.affiliation: Biostatistician, School of Medicine and Public Health, University of Newcastle, NSW, and; Teaching and Research Unit, Gosford Hospital, Central Coast Local Health District, Gosford, NSW, Australia.
authors.forename: Jeryl Lynn
authors.initials: JL
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000552:Ambulances; D004636:Emergency Service, Hospital; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009517:New South Wales; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Australian laws; Mental Health Act; ambulance; ambulance officer; emergency department; involuntary psychiatric admission; mental health law; suicidal behaviour