Keene J, Rodriguez J
University of Reading, Reading, UK.
Eur J Public Health. 2007 Aug;17(4):387-93. doi: 10.1093/eurpub/ckl248. Epub 2006 Oct 25.
Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole.
Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm.
Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures.
The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.
先前的研究结果表明，心理健康问题在急诊科很常见；然而，关于心理健康人群中与健康相关问题的程度以及急诊服务使用情况的研究却很少。
采用记录链接方法，对一个地理区域内三年来全体医疗和心理健康护理人群中的心理健康、年龄、性别以及与健康相关的伤害之间的关联进行映射。通过检查与健康相关的伤害模式，生成了精神病急诊患者的准确概况，从而能够识别增加伤害易感性的因素。
在625964人的总人口中，10.7%的人在三年内联系过事故与急救（A&E）部门，在二级护理心理健康人群中这一比例上升至28.6%。总体而言以及在心理健康人群中，年轻男性和老年女性更有可能联系A&E部门，并且也更有可能频繁前往A&E部门。出现了四类不同的前往A&E部门的心理健康患者（类型）：年轻男性频繁前往，有自我伤害和其他创伤性损伤；年轻女性也有自我伤害行为；患有多种疾病的老年患者；以及患有心脏病和骨折的非常老年患者。
该研究表明，在整个心理健康人群中，A&E服务的使用增加，且与健康相关的需求未得到满足。它识别出了特别容易发生事故和自我伤害的特定“护理人群”，并强调需要为可能无法有效获得传统健康和社会护理服务的精神病群体提供有针对性的服务。
