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Interventions to Reduce Repeat Presentations to Hospital Emergency Departments for Mental Health Concerns: A Scoping Review of the Literature.

作者信息

Mao Wanying, Shalaby Reham, Agyapong Vincent Israel Opoku

机构信息

Department of Psychiatry, University of Alberta, Edmonton, AB T6G 1C9, Canada.

Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans, Memorial Lane, 8th Floor Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada.

出版信息

Healthcare (Basel). 2023 Apr 18;11(8):1161. doi: 10.3390/healthcare11081161.


DOI:10.3390/healthcare11081161
PMID:37107995
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10138571/
Abstract

BACKGROUND: The number of readmissions to the emergency department (ED) for mental health services each year is significant, which increases healthcare costs and negatively affects the morale and quality of life of patients and their families. OBJECT: This scoping review aimed to establish a better understanding of interventions that have been implemented to reduce psychiatric patient readmission and ED use within the ED, to identify areas for improvement, and therefore to assist in the development of more effective actions in the future. METHOD: The scoping review was conducted on several bibliographic databases to identify relevant studies. Two researchers independently screened and reviewed titles, abstracts, and full-text articles that met the inclusion criteria. Using Covidence software, 26 out of 6951 studies were eligible for inclusion in this scoping review based on the PRISMA checklist. Data were extracted, collated, summarized, presented, and discussed. RESULT: This review identified 26 studies which examined interventions aimed to reduce ED visits, such as the High Alert Program (HAP), the Patient-Centered Medical Home (PCMH), the Primary Behavioral Health Care Integration (PBHCI), and the Collaborative Care (CC) Program, etc. Twenty-three of the studies were conducted in North America, while the rest were conducted in Europe and Australia. A total of 16 studies examined interventions directed to any mental health conditions, while the rest addressed specific health conditions, such as substance use disorders, schizophrenia, anxiety, depression. Interventions involved comprehensive and multidisciplinary services, incorporation of evidence-based behavioral and pharmacological strategies, and emphasized the case management that was found to be effective. Additionally, there was a marked consideration for diverse mental health groups, such as those with substance use disorder and of young age. Most interventions showed a positive effect on reducing psychiatric ED visits. CONCLUSION: Various initiatives have been implemented worldwide to reduce the number of emergency department visits and the associated burden on healthcare systems. This review highlights the greater need for developing more accessible interventions, as well as setting up a comprehensive community health care system aiming to reduce frequent ED presentations.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/7463605ea6c6/healthcare-11-01161-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/6009b1b0e37e/healthcare-11-01161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/77d673cab9f8/healthcare-11-01161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/483afd91493b/healthcare-11-01161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/7463605ea6c6/healthcare-11-01161-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/6009b1b0e37e/healthcare-11-01161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/77d673cab9f8/healthcare-11-01161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/483afd91493b/healthcare-11-01161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b673/10138571/7463605ea6c6/healthcare-11-01161-g004.jpg

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[5]
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本文引用的文献

[1]
Reducing readmission rates for individuals discharged from acute psychiatric care in Alberta using peer and text message support: Protocol for an innovative supportive program.

BMC Health Serv Res. 2022-3-12

[2]
Emergency department use for mental and substance use disorders: descriptive analysis of population-based, linked administrative data in British Columbia, Canada.

BMJ Open. 2022-1-13

[3]
A quarter of century after: The changing ecology of psychiatric emergency services.

Asia Pac Psychiatry. 2022-9

[4]
Bridge clinic buprenorphine program decreases emergency department visits.

J Subst Abuse Treat. 2021-11

[5]
Reducing length of stay and return visits for emergency department pediatric mental health presentations.

CJEM. 2021-1

[6]
10-Year Trends of Emergency Department Visits, Wait Time, and Length of Stay among Adults with Mental Health and Substance use Disorders in the United States.

Psychiatr Q. 2021-9

[7]
Text4Hope: Receiving Daily Supportive Text Messages for 3 Months During the COVID-19 Pandemic Reduces Stress, Anxiety, and Depression.

Disaster Med Public Health Prep. 2022-8

[8]
Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans.

Am J Health Syst Pharm. 2021-2-8

[9]
Continuity of Mental Health Care at Community Health Centers and Reduced Emergency Department Visits for Suicidal Ideation/Self-Harm.

Community Ment Health J. 2021-8

[10]
Preliminary Assessment of a Novel Continuum-of-Care Model for Young People With Autism Spectrum Disorders.

Psychiatr Serv. 2020-12-1

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