Treating immigrant patients in psychiatric emergency rooms

Area of Science:

• Psychiatry
• Public Health
• Sociology

Background:

• Emergency department psychiatric encounters involve complex patient and clinician factors.
• Understanding these factors is crucial for equitable diagnosis and treatment, particularly concerning coercive measures.

Purpose of the Study:

• To investigate the association between patient variables (origin, gender, language) and clinician aspects (diagnostic certainty, comfort) with psychiatric diagnoses and coercive measure use.
• To identify ethnic, gender, and language-related disparities in emergency psychiatric care.

Main Methods:

• Descriptive cross-sectional study of 467 psychiatric emergency room visits in Barcelona (2007-2015).
• Logistic models were used to assess associations between patient/clinician variables and outcomes (diagnosis, coercive measures).

Main Results:

• Female patients received fewer coercive measures and intramuscular medications than males.
• Ethnic/racial and gender disparities were observed in specific diagnoses.
• Lower Spanish proficiency correlated with a higher likelihood of psychosis diagnosis.
• Clinician diagnostic certainty positively correlated with clinician comfort with the patient.

Conclusions:

• Patient's geographical origin, gender, language proficiency, and clinician's subjective assessments influence psychiatric diagnoses and the use of coercive measures.
• There is a need for enhanced cultural competency training and interpreter services in psychiatric emergency settings.