Emergency Department Presentations for Mental Health Crisis: Comparing ED-Only Care With Transfer to a Crisis...

Emergency departments (EDs) are often the first point of contact for individuals experiencing mental health crises; however, they remain unsuitable to cater to the complex needs of mental health patients. As an alternative, Crisis Stabilisation Units (CSUs) are increasingly being implemented to provide a more therapeutic setting for patients to receive specialised emergency mental health care. However, to date, the evaluation of CSUs in comparison to traditional EDs remains limited. This study aims to examine whether there are significant differences between patients who are transferred to the CSU and those treated solely in the ED in terms of patient characteristics, length of stay and re-presentation. Using ED data obtained from the Gold Coast Hospital and Health Service, this retrospective study analysed 18 240 mental-health-related presentations made between August 2021 and August 2023. Descriptive and inferential statistics were used to examine differences between patients who completed treatment in the ED and those who were transferred to the CSU. Patients who were transferred to the CSU were found to have a shorter length of stay than those who completed treatment in the ED. CSU patients were more likely to walk in and had lower triage ratings, whereas patients treated in the ED were more likely to arrive by ambulance. Re-presentation rates did not significantly differ between those who completed treatment in the ED and those who were transferred to the CSU. This study adds to the limited work on alternative crisis care models by comparing CSU and ED services for emergency mental health presentations. Findings suggest that CSUs may effectively reduce repeat ED presentations, particularly for patients with moderate clinical acuity. However, the complexity of mental health crises extends beyond basic demographic factors, underscoring the need for deeper, multifaceted research to fully understand patient experiences and service effectiveness.