Department of Psychiatry, Women's College Hospital and Research Institute (Barker, Vigod), Li Ka Shing Knowledge Institute, St. Michael's Hospital (Sunderji), and Centre for Addiction and Mental Health (Kurdyak, Stergiopoulos), all at University of Toronto, Toronto; ICES, Toronto (Barker, Kurdyak, Gonzalez, Kopp, Vigod); Waypoint Centre for Mental Health Care and Research Institute, Penetanguishene, Ontario, Canada (Sunderji); Health Canada, Ottawa (Gonzalez).
Psychiatr Serv. 2020 Jun 1;71(6):616-619. doi: 10.1176/appi.ps.201900466. Epub 2020 Feb 24.
Follow-up after psychiatric emergency department (ED) contact is key to optimizing outcomes for vulnerable patients. We aimed to quantify the likelihood of receiving outpatient mental health care after psychiatric ED visits in a population-level sample.
Among individuals who presented for a psychiatric ED visit in Ontario, Canada (2010-2012) and were not admitted to hospital (N=143,662), the authors estimated the likelihood of outpatient physician mental health care within 14 days post-ED visit and compared this across presenting diagnoses.
About 40.2% (N=57,797) had a follow-up mental health visit within 14 days post-ED. Follow-up was lower among individuals presenting with substance use disorders (25.2%) than among those presenting with disorders not primarily related to substance use (44.5%) (χ=3,784.7, df=1, p<0.001). Follow-up differed among those presenting with schizophrenia (46.4%), bipolar disorder (56.1%), and major depressive disorder (51.1%) (χ=61.7, df=2, p<0.001).
Post-ED outpatient mental health follow-up is low. Systemwide coordination is needed to connect these high-acuity patients with care, especially those with presentations related to substance use.
精神科急诊（ED）接触后的随访对于优化弱势患者的结局至关重要。我们旨在量化在人群水平样本中，精神科 ED 就诊后接受门诊心理健康护理的可能性。
在加拿大安大略省（2010-2012 年）就诊但未住院的个体中（N=143662），作者估计了 ED 就诊后 14 天内接受门诊医生心理健康护理的可能性，并比较了不同就诊诊断的情况。
约 40.2%（N=57797）在 ED 就诊后 14 天内进行了随访心理健康就诊。与主要与物质使用无关的疾病（44.5%）相比，物质使用障碍（25.2%）的个体随访率较低（χ=3784.7，df=1，p<0.001）。与精神分裂症（46.4%）、双相情感障碍（56.1%）和重度抑郁症（51.1%）相比，就诊的患者随访率不同（χ=61.7，df=2，p<0.001）。
ED 后门诊心理健康随访率较低。需要进行全系统协调，将这些高急症患者与护理联系起来，特别是那些与物质使用相关的就诊患者。
