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A psychiatric emergency walk-in clinic: a dangerous substitute for primary care?

Published online by Cambridge University Press:  02 January 2018

Jane F. Whittaker
Affiliation:
Department of Psychiatry, Withington Hospital, West Didsbury, Manchester M20 8LR
Louis Appleby
Affiliation:
Department of Psychiatry, Withington Hospital, West Didsbury, Manchester M20 8LR
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Abstract

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Data were collected on a six month sample of patients attending a psychiatric emergency walk-in clinic (n=378), based on the clinical impressions of the interviewing doctor. This information was then compared with a hypothetical model emergency service on the following five items: nature of patient problem, severity of problem, diagnosis, referring agent and current contact with psychiatric services. The severity of the perceived threat to the interviewer was recorded. Only 4.7% of referrals conformed to the hypothetical model on all five criteria. The majority of patients referred themselves, and the problems of self-referrals were significantly less severe than those of general practitioner referrals; 17.2% of consultations were perceived by the interviewing doctor as presenting a moderate or severe threat to his or her safety. The findings suggest that such an emergency facility operates as a form of primary care and is therefore inappropriately used. The level of perceived threat to interviewing doctors is unacceptably high.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1994

References

Department of Health (1989) Working for Patients. London: HMSO.Google Scholar
Fottrell, E. (1980) A study of violent behaviour among patients in psychiatric hospitals. British Journal of Psychiatry, 136, 216221.CrossRefGoogle ScholarPubMed
Gater, Jackson G., Tantam, D. D. et al (1993) A new community mental health team based in primary care: a description of the service and its effect on service use in the first year. British Journal of Psychiatry, 162, 375384.Google Scholar
Lewis, G & Appleby, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 4449.Google Scholar
Noble, P & Rodgers, S (1984) Violence by psychiatric inpatients. British Journal of Psychiatry, 145, 384390.Google Scholar
Royal College of Psychiatrists (1991) Report of the Collegiate Trainees' Committee Working Party on training of junior psychiatrists with respect to violent incidents. Psychiatric Bulletin, 15, 243246.Google Scholar
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