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Acute psychiatric problems in an A&E Department

L Hislop1, P T Grant, I Smith

  • 1Accident & Emergency Department, Western Infirmary, Glasgow.

Health Bulletin
|March 1, 1996
PubMed
Summary

Patients with psychiatric issues frequently visit the Accident & Emergency (A&E) department, with many requiring psychiatric follow-up. Early intervention by an on-site psychiatrist could improve patient management and reduce delays.

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Area of Science:

  • Psychiatry
  • Emergency Medicine
  • Public Health

Background:

  • Accident & Emergency (A&E) departments manage patients with diverse psychiatric conditions.
  • Self-referral is common among psychiatric patients presenting to A&E.
  • A significant proportion of psychiatric A&E attendances have a history of mental illness and present with self-harm.

Purpose of the Study:

  • To investigate the characteristics and outcomes of psychiatric patients attending the A&E department.
  • To assess the need for psychiatric input among A&E attendees.
  • To identify factors correlating with the need for admission or follow-up in self-harm cases.

Main Methods:

  • A four-month observational study of psychiatric patients at the Western Infirmary, Glasgow.
  • Exclusion of patients requiring admission to other specialties (e.g., overdoses).
  • Data collection on patient history, presentation, alcohol use, referral pathways, and outcomes.

Main Results:

  • Forty-seven self-referred patients attended A&E; 77% had a prior psychiatric history.
  • Self-harm was the reason for presentation in 66% of cases, often outside normal working hours.
  • 62% were referred to a duty psychiatrist, with 38% admitted and 45% discharged with follow-up; 52% of those initially assessed were later discharged.

Conclusions:

  • The majority of psychiatric patients seen in A&E require psychiatric services.
  • Known suicide risk factors correlate with the need for admission or follow-up in self-harm patients.
  • On-site psychiatric availability could streamline management and reduce A&E delays.

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