title: Predictors for clinical deterioration of mental state in patients assessed by telephone-based mental health triage.
abstract: Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone-based mental health triage. The main objective of the research was to produce knowledge to improve understandings of mental deterioration that can be used to inform early detection, intervention, and prevention strategies at the point of triage. The results of the study found that the clinical profile of admitted patients was one of complexity and severity. Admitted patients were more likely to have had complex psychiatric histories with multiple psychiatric admissions, severe psychotic symptoms, a history of treatment non-adherence, and poorer social functioning than non-admitted patients.
authors: School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
authors: Natisha
authors: N
authors: Sands
authors: Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia.
authors: Stephen
authors: S
authors: Elsom
authors: Barwon Health, Geelong, Victoria, Australia.
authors: Rebecca
authors: R
authors: Corbett
authors: Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia.
authors: Sandra
authors: S
authors: Keppich-Arnold
authors: Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia.
authors: Roshani
authors: R
authors: Prematunga
authors: School of Medicine, Deakin University, Geelong, Victoria, Australia.
authors: Michael
authors: M
authors: Berk
authors: School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
authors: Julie
authors: J
authors: Considine
mesh_terms: D000328:Adult; D000075902:Clinical Deterioration; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008605:Mental Health Services; D012189:Retrospective Studies; D012307:Risk Factors; D013689:Telephone; D014218:Triage / Q000379:methods*
keywords: clinical deterioration; mental health; patient safety; triage