How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study

International Journal of Mental Health Systems

Steinar Hunskaar¹  Tone Morken¹  Ingrid H Johansen¹ 

[1] Department of Public Health and Primary Health Care, University of Bergen, Box 7800, 5020, Bergen, Norway

关键词: Coercion;    Primary healthcare;    Emergency medical services;    Mental health services;    After-hours care;   

Others  :  801963
DOI  :  10.1186/1752-4458-6-3

 received in 2011-11-25, accepted in 2012-04-20,  发布年份 2012

【 摘 要 】

Background

Low-threshold and out-of-hours services play an important role in the emergency care for people with mental illness. In Norway casualty clinic doctors are responsible for a substantial share of acute referrals to psychiatric wards. This study’s aim was to identify patients contacting the casualty clinic for mental illness related problems and study interventions and diagnoses.

Methods

At four Norwegian casualty clinics information on treatment, diagnoses and referral were retrieved from the medical records of patients judged by doctors to present problems related to mental illness including substance misuse. Also, routine information and relation to mental illness were gathered for all consecutive contacts to the casualty clinics.

Results

In the initial contacts to the casualty clinics (n = 28527) a relation to mental illness was reported in 2.5% of contacts, whereas the corresponding proportion in the doctor registered consultations, home-visits and emergency call-outs (n = 9487) was 9.3%. Compared to other contacts, mental illness contacts were relatively more urgent and more frequent during night time. Common interventions were advice from a nurse, laboratory testing, prescriptions and minor surgical treatment. A third of patients in contact with doctors were referred to in-patient treatment, mostly non-psychiatric wards. Many patients were not given diagnoses signalling mental problems. When police was involved, they often presented the patient for examination.

Conclusions

Most mental illness related contacts are managed in Norwegian casualty clinics without referral to in-patient care. The patients benefit from a wide range of interventions, of which psychiatric admission is only one.

【 授权许可】

   
2012 Johansen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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