Hummelen Ruben, Lee Heather, Russell-Mahoney Barbara, Maxwell Sadie, Semple Doug, Osmond Dean, Asokan Shanthive, Poirier Jenna, Kelly Len
Northern Ontario School of Medicine, Sioux Lookout, ON, Canada.
Sioux Lookout Meno Ya Win Health Centre, Box 489, Sioux Lookout, ON, P8T 1A8, Canada.
CJEM. 2022 Mar;24(2):161-166. doi: 10.1007/s43678-021-00223-7. Epub 2021 Dec 2.
Providing emergency mental health services for populations in remote rural areas of Canada is challenging. Program needs are distinct. We describe the emergency mental health workload and service needs at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) in northwest Ontario.
Emergency department (ED) data were collected for mental health, addiction and self-harm diagnoses (MHA) in 2018/2019. Comparisons were made to similar sized provincial hospitals and EDs. Mental health admissions data from Oct 1, 2018 to Dec 31, 2019 were manually collected from hospital medical charts for demographics, suicide attempts/ideation and frequency of applications for Form 1 psychiatric assessment.
The volume of MHA ED visits as a percentage of total ED visits was 4 times higher at SLMHC when compared to both the 67 other Ontario level C hospitals (< 100 beds) and the 15 level C hospital with a similar volume of ED visits (15,000-20,000), (15% vs 4%). Self-harm presentations were 308 at SLMHC versus an average of 42 ± 37 at the 15 level C hospitals with a similar ED volume. From Oct 1, 2019 to Dec 31, 2019, there were 49 patients requiring a Form 1, with an average wait time of 55 h before transfer to a schedule 1 facility.
There is an increased level of mental health, addiction and self-harm presentations in this northern ED. Lack of alternative resources indicate the need for the development of an integrated model of mental health care service. Reliance on the ED for crisis management indicates the need for the development of more regionally relevant models of care.
为加拿大偏远农村地区的人群提供紧急心理健康服务具有挑战性。项目需求各不相同。我们描述了安大略省西北部苏圣洛朗·梅诺·亚温健康中心（SLMHC）的紧急心理健康工作量和服务需求。
收集了2018/2019年急诊科（ED）关于心理健康、成瘾和自残诊断（MHA）的数据。与规模类似的省级医院和急诊科进行了比较。2018年10月1日至2019年12月31日的心理健康住院数据是从医院病历中手动收集的，内容包括人口统计学信息、自杀未遂/自杀意念以及1号表格精神科评估申请频率。
与安大略省其他67家C级医院（床位<100张）以及15家急诊量类似（15000 - 20000）的C级医院相比，SLMHC的MHA急诊就诊量占总急诊就诊量的百分比高出4倍（15%对4%）。SLMHC的自残病例为308例，而急诊量类似的15家C级医院平均为42±37例。2019年10月1日至2019年12月31日，有49名患者需要1号表格评估，转至1类设施前的平均等待时间为55小时。
该北部急诊科的心理健康、成瘾和自残病例有所增加。缺乏替代资源表明需要开发综合心理健康护理服务模式。依赖急诊科进行危机管理表明需要开发更符合该地区情况的护理模式。
