title: Disability and Functioning of Patients Who Use Psychiatric Hospital Emergency Services.
abstract: OBJECTIVE
  First, to compare the level of disability and functioning of patients who access psychiatric emergency services by diagnosis and service use frequency. Second, to compare patients who access psychiatric emergency services to the general population in terms of demographics and the level of disability and functioning.
  
  
  METHODS
  Data from 420 patients were obtained by time-based sampling from August 2011 to February 2012 in the emergency department of a psychiatric hospital that provides services to adolescents and adults. The 2011 and 2012 Centre for Addiction and Mental Health Monitor surveys were used as a representative adult general population sample. Disability and functioning were measured using the World Health Organization Disability Assessment Schedule (WHODAS).
  
  
  RESULTS
  Variation in WHODAS scores among psychiatric emergency patients was observed within but not between diagnostic categories and within frequency of use of these services categories. Psychiatric emergency patients had a mean WHODAS score of 38.0, significantly higher (P < .001) than the mean score of 5.0 for the general population; however, there was overlap in the distribution of WHODAS scores. Compared to the general population, psychiatric emergency patients were more likely to be men, younger in age, never married, and unemployed or a student.
  
  
  CONCLUSIONS
  Psychiatric emergency patients are demographically different when compared to the general population. Furthermore, since disability and functioning are highly variable within but not between psychiatric diagnostic categories, data on disability and functioning should be collected for psychiatric emergency patients, in addition to diagnosis data, to more accurately align patients with the appropriate intensity of services.
authors.affiliation: CAMH, 33 Russell St, Toronto, Ontario, Canada M5S 2S1. Kevin.david.shield@gmail.com.|Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Shield
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Clinical Evaluative Sciences, Faculty of Medicine, University of Toronto, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Kurdyak
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Canada.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Shuper
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada.|Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Canada.|Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada.|Institute of Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D009864:Ontario; D066107:Social Skills; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult