Higgins Oliver, Sheather-Reid Rachel B, Chalup Stephan K, Wilson Rhonda L
RMIT University, Melbourne, Australia.
Central Coast Local Health District, New South Wales, Australia.
Int J Ment Health Nurs. 2025 Feb;34(1):e13414. doi: 10.1111/inm.13414. Epub 2024 Sep 16.
Emergency Department (ED) presentations for Mental Health (MH) help-seeking have been rising rapidly, with EDs as the main entry point for most individuals in Australia. The objective of this retrospective cohort study was to analyse the sociodemographic and presentation features of people who sought mental healthcare in two EDs located in a regional coastal setting in New South Wales (NSW), Australia from 2016 to 2021. This article is a part of a broader research study on the utilisation of machine learning in MH. The objective of this study is to identify the factors that lead to the admission of individuals to an MH inpatient facility when they seek MH care in an ED. Data were collected using existing records and analysed using descriptive univariate analysis with statistical significance between the two sites was determined using Chi squared test, p < 0.05. Two main themes characterise dominant help-seeking dynamics for MH conditions in ED, suicidal ideation, and access and egress pathways. The main findings indicate that suicidal ideation was the most common presenting problem (38.19%). People presenting to ED who 'Did not wait' or 'Left at own risk' accounted for 10.20% of departures from ED. A large number of presentations arrived via the ambulance, accounting for 45.91%. A large proportion of presentations are related to a potentially life-threatening condition (suicidal ideation). The largest proportion of triage code 1 'Resuscitation' was for people with presenting problem of 'Behavioural Disturbance'. Departure and arrival dynamics need to be better understood in consultation with community and lived experience groups to improve future service alignment with the access and egress pathways for emergency MH care.
前往急诊科（ED）寻求心理健康（MH）帮助的人数一直在迅速增加，在澳大利亚，急诊科是大多数人寻求心理健康帮助的主要入口。这项回顾性队列研究的目的是分析2016年至2021年期间在澳大利亚新南威尔士州（NSW）沿海地区的两个急诊科寻求心理健康护理的人群的社会人口统计学特征和就诊特征。本文是关于机器学习在心理健康领域应用的更广泛研究的一部分。本研究的目的是确定在急诊科寻求心理健康护理的个体被收治到心理健康住院机构的影响因素。数据通过现有记录收集，并使用描述性单变量分析进行分析，使用卡方检验确定两个地点之间的统计学显著性，p < 0.05。急诊科中，心理健康问题的主要求助动态有两个主要主题，即自杀意念以及进出途径。主要研究结果表明，自杀意念是最常见的就诊问题（38.19%）。在急诊科“未等待”或“自行离开风险自负”的就诊者占离开急诊科人数的10.20%。大量就诊者通过救护车送来，占45.91%。很大一部分就诊与潜在的危及生命的状况（自杀意念）有关。分诊代码1“复苏”的最大比例是针对存在“行为障碍”就诊问题的人群。需要与社区和有实际经历的群体协商，更好地了解进出动态，以改善未来紧急心理健康护理进出途径的服务匹配度。
