[Psychiatric emergencies in the context of community mental health services]

Psychiatric services dispensed according to geographic sectors has been a reality of the Montréal area psychiatric care system for about fifteen years. In a dense urban environment where the territorial limits of sectors do not necessarily follow the borders of residential areas, divisions by sector can create serious access problems. On a different note, when the distribution of mental health services is patterned after the main urban arteries, sectorialization becomes the validation of an existing situation, its success thereby ensured by the force of circumstances. In this article, the access to emergency psychiatric services over the sectorialized territory of Ile Jesus is examined based on archival data provided by Sacré-Coeur and Cité de la Santé hospitals. The data reveal that patients with a psychiatric ailment present themselves to the emergency ward of the hospital of their sector. These patients of emergency services are characterized by usage patterns that are no different from those of users of all types of health care services, psychiatric or not, regardless of the reason of the visit. However, the place of use of sectorialized psychiatric services has a halo effect on non-sectorialized psychiatric services. The impact of sectorialization on the usage and access of services is therefore a complex phenomenon.