Sociodemographic characteristics and clinical outcomes for people presenting to emergency departments with mental health diagnoses

Abstract

Background: Hospital emergency departments (EDs) are experiencing a growth in presentations with mental health (MH) diagnoses.

Aim: Describe and compare sociodemographic characteristics and clinical outcomes for people with MH and non-MH diagnoses.

Methods: A retrospective study examined routinely collected data for ED presentations in a health district in western Sydney, Australia from 2016 to 2019. Regression models examined variables according to MH status, overall and by age.

Results: Individuals with MH diagnoses accounted for 3.4% of 647,787 ED presentations. MH presentations were most commonly female (51.5%), aged 16-39 years (62.5%), arrived after hours (60.3%) and via ambulance (52.8%). MH presentations were more likely to be triaged category 2 (OR = 1.58,95%CI = 1.54-1.63) and not seen on time (OR = 1.20,95%CI = 1.17-1.24). They had higher odds of a longer ED stay (OR = 1.96,95%CI = 1.90-20.1), after which they were less likely to be admitted (OR = 0.56, 95%CI = 0.55-0.58) and more likely to be transferred (OR = 3.81,95%CI = 3.66-3.97) or leave before treatment was completed (OR = 1.83,95%CI = 1.74-1.92).

Conclusion: Characteristics and outcomes for people presenting to ED with a MH diagnosis significantly differ from those without a MH diagnosis. Provision of timely care is a particular concern. Identifying causes for delays within and external to the ED, and implementing targeted strategies to ameliorate them are required to optimise care.

Keywords: Age; Emergency department; Length of stay; Mental health; Outcomes; Patient characteristics; Separation mode.