Is psychiatric emergency service (PES) use increasing over time?

Area of Science:

• Psychiatry
• Health Services Research

Background:

• Recent studies indicate rising emergency department (ED) visits for mental health reasons, with differing diagnostic profiles compared to psychiatric emergency services (PES).
• Limited research exists on long-term PES utilization, with older studies suggesting deinstitutionalization as a factor.
• This study aimed to analyze recent PES use trends and the impact of factors like population growth.

Purpose of the Study:

• To assess psychiatric emergency service (PES) utilization rates over a recent time frame.
• To investigate the influence of non-specific factors, such as population growth, on PES use.
• To differentiate between actual increases in mental health needs and redistribution of existing patient populations.

Main Methods:

• Collected annual visit data from multiple PES sites over 11-12 year periods.
• Compared PES utilization in stable versus growing populations (catchment area and regional).
• Employed conservative criteria to identify trends or significant increases in utilization.

Main Results:

• PES visits exhibited 7-15% annual variability across all sites.
• Sites with increasing surrounding populations showed a trend or significant increase in PES utilization (12-19%).
• PES utilization remained stable in areas with stable populations.

Conclusions:

• Detecting stable changes in PES utilization requires long observation periods.
• Population growth is a contributing factor to increased PES use, but not the sole cause.
• Organizational changes in mental healthcare may redistribute existing patients to PES, creating an apparent rather than a real increase in demand.