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Emergency psychiatry: a neglected area of a Cinderella service?

Published online by Cambridge University Press:  13 June 2014

Robert F Kehoe
Affiliation:
Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF
Ian M Pullen
Affiliation:
Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF

Abstract

Objectives: To describe existing Scottish psychiatric emergency services, particularly the staffing levels and supervision of junior staff, to assess the level of recording of the urgency of referrals to such services and to determine the approximate rates of emergency presentations. Method: A postal questionnaire was sent to all 29 Scottish psychiatric hospitals, addressed to the physician superintendent or the consultant in charge of emergency services. Twenty-six were returned and further details on these and the other three services were clarified by telephone contact with medical records and medical staff. Description of services, number of presentations, staffing levels and degree of supervision were recorded. Rates of referral were estimated for Health Board populations. Results: Services varied from hospital based walk-in clinics through to community orientated domicillary assessment services. Emergency presentations are usually seen by junior staff in a psychiatric hospital outpatient department, a psychiatric ward or at an accident and emergency department. Out of hours supervision is typically by telephone advice from a consultant. Rates of emergency presentations based on collected and estimated figures were highest in urban areas. Conclusions: Scottish psychiatric emergency services are disparate in nature but all provide a 24 hour service. There is a lack of reliably collected data on the urgency of referrals but estimates suggest that there is a greater need for emergency psychiatric care in the large urban areas. Working definitions are proposed to assist in the classification of the urgency of referrals.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1992

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References

1.Goldberg, D, Huxley, P. Mental illness in the community. London: Tavistock, 1980.Google Scholar
2.Oldham, JM, Lin, A, Breslin, L. Comprehensive psychiatric emergency services. Psychiatr Q 1990; 61: 5767.CrossRefGoogle ScholarPubMed
3.Lim, MH. A psychiatric emergency clinic: a study of attendances over six months. Br J Psychiatry 1983; 143: 460466.CrossRefGoogle Scholar
4.Blaney, D, West, A. Out of hours referrals to a general psychiatric hospital. Health Bulletin 1987; 45: 6770.Google ScholarPubMed
5.Haw, C, Lanceley, C, Vickers, S. Patients at a psychiatric walk-in clinic – who, why, how and when. Bulletin of the Royal College of Psychiatrists 1987; 11: 329332.CrossRefGoogle Scholar
6.Boardman, AP, Bouras, N. Self referrals to a community psychiatric clinic. Bulletin of the Royal College of Psychiatrists 1989; 13: 490492.Google Scholar
7.Kehoe, RF, Newton, R. Do patients need a psychiatric emergency cliic? Bulletin of the Royal College of Psychiatrists 1990; 14: 470472.Google Scholar
8.Common Services Agency for the Scottish Health Service. Scottish health statistics; vol 30. Edinburgh: HMSO, 1988.Google Scholar
9. Royal Edinburgh Hospital Annual Statistics 1990 (unpublished).Google Scholar
10.Frankel, S, Farrow, A, West, R. Non-attendance or non-invitation? A case-controlled study of failed outpatient appointments. BMJ 1989; 298: 13431345.CrossRefGoogle ScholarPubMed
11.Rowland, M, Porter, R, Matthews, J, Redden, J, Simonds, G, Bewley, B. Improving care: a study of orthopaedic outpatient referrals. BMJ 1991; 302: 11241128.CrossRefGoogle Scholar
12.Virji, A. A study of patients attending without appointments in an urban general practice. BMJ 1990; 301: 2226.CrossRefGoogle Scholar
13.Department of Health. Caring for people: community care in the next decade and beyond. London: HMSO, 1989.Google Scholar
14.Brown, TM, Scott, AI, Pullen, IM. Handbook of emergency psychiatry. Edinburgh: Churchill Livingstone, 1990.Google Scholar