Emergency Department Visits Related to Schizophrenia Among Adults Aged 18-64: United States, 2009-2011.

ED care is important for the treatment of acute presentations of schizophrenia and may serve as a safety net for schizophrenic patients not otherwise receiving care (4,5). This analysis of National Hospital Ambulatory Medical Care Survey (NHAMCS) data indicates that during 2009-2011, an average of 382,000 ED visits related to schizophrenia occurred each year among adults aged 18-64, corresponding to an overall visit rate of 20.1 per 10,000 adults. A visit having a first-, second-, or third-listed diagnosis of schizophrenia (i.e., whether the visit was directly or indirectly related to schizophrenia) was included in the analysis to provide a broader description of ED use by these patients. The distribution of the primary diagnosis of visits related to schizophrenia was: schizophrenia (58.8%), another mental disorder (15.4%), and a nonmental health disorder (25.7%) (data not shown). Among adults aged 18-64, the rate for ED visits related to schizophrenia was about twice as high for men as for women. Public insurance (Medicaid, Medicare, or dual Medicare and Medicaid) was more frequently the primary expected source of payment for ED visits related to schizophrenia compared with ED visits not related to schizophrenia. ED visits related to schizophrenia were more frequently made by patients who were homeless compared with ED visits not related to schizophrenia. About one-third of ED visits related to schizophrenia resulted in a hospital admission, and another 16.7% resulted in a transfer to a psychiatric hospital--both higher than the percentages for ED visits not related to schizophrenia. One of the goals of Healthy People 2020 is to improve mental health through prevention and by ensuring access to appropriate, quality mental health services (6). National data on the rates and characteristics of ED visits related to schizophrenia will help policymakers and practitioners address disparities and meet this goal.