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Psychiatric presentations to an A&E department

Published online by Cambridge University Press:  02 January 2018

David Ellis*
Affiliation:
Waterlow Unit, Camden and Islington Community Health Services NHS Trust, Highgate Hill, London N19 SNF
Simon Lewis
Affiliation:
Waterlow Unit, Camden and Islington Community Health Services NHS Trust, Highgate Hill, London N19 SNF
*
Correspondence
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Abstract

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A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months. Forty per cent presented with deliberate self-harm and 25% of these left before being assessed. Twenty per cent of those with problems compatible with a diagnosis of severe mental illness also left before being seen by a doctor. Differences between presentations ‘out-of-hours' and ‘in-hours' are described. Factors predicting admission were: previous psychiatric admission, symptoms of a psychotic or affective disorder and non-permanent accommodation. The survey has implications for the process of triage in A&E departments and the organisation of mental health liaison services.

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 © 1997 The Royal College of Psychiatrists

References

British Medical Journal News (1996) BMA suggests ways to end long waits in casualty departments. British Medical Journal, 313, 646.CrossRefGoogle Scholar
Bindman, A. B. (1995) Triage in accident and emergency departments. British Medical Journal, 311, 404.CrossRefGoogle ScholarPubMed
Brown, A. & Cooper, A. F. (1987) The impact of liaison psychiatry service on patterns of referral in a general hospital. British Journal of Psychiatry, 150, 8387.CrossRefGoogle ScholarPubMed
Brillman, J. C., Doezema, D., Tandberg, D., et al (1996) Triage: limitations in predicting need for emergency care and hospital admission. Annals of Emergency Medicine, 27, 493500.CrossRefGoogle ScholarPubMed
Dale, J., Green, J., Reid, F., et al (1995) Primary care in the accident and emergency department. British Medical Journal, 311, 423426.CrossRefGoogle ScholarPubMed
George, S., Read, S., Williams, B. (1995) Nurse triage time increases emergency department waiting times. British Medical Journal, 311, 1305.CrossRefGoogle Scholar
George, S., Read, S., Westlake, L., et al (1992) Evaluation of nurse triage in a British accident and emergency department. British Medical Journal, 304, 876878.CrossRefGoogle Scholar
Hollander, D. & Slater, M. S. (1994) ‘Sony, no beds’: a problem for acute psychiatric admissions. Psychiatric Bulletin, 18, 534537.CrossRefGoogle Scholar
Lowe, R. A., Bindman, A. B., Ulrich, S. K., et al (1994) Refusing care to emergency department patients: evaluation of published triage guidelines. Annals of Emergency Medicine, 23, 286293.CrossRefGoogle ScholarPubMed
Rosenzweig, L. (1992) Psychiatric triage: a cost-effective approach to quality management in mental health. Journal of Psychosocial Nursing and Mental Health Services, 30, 58.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (1996) Psychiatric Services to Accident and Emergency Departments (Council Report CR43). London: Royal College of Psychiatrists.Google Scholar
Schnyder, U., Valach, L. & Heim, E. (1995) Coping and the decision to hospitalize in emergency psychiatry. General Hospital Psychiatry, 17, 362370.CrossRefGoogle ScholarPubMed
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