Psychosocial stressors contributing to emergency psychiatric service utilization in a sample of ethno-culturally diverse clients with psychosis in Toronto

BMC Psychiatry

Research Article

Andrew Tuck¹  Martin Rotenberg²  Kwame McKenzie² 

[1] Centre for Addiction and Mental Health, 33 Russell Street, Room 2017, M5S 3B1, Toronto, ON, Canada;Department of Psychiatry, University of Toronto, Toronto, ON, Canada;Centre for Addiction and Mental Health, 33 Russell Street, Room 2017, M5S 3B1, Toronto, ON, Canada;

关键词: Psychosis;    Ethnicity;    Psychosocial stressors;    Emergency department;   

DOI  :  10.1186/s12888-017-1487-8

 received in 2017-06-28, accepted in 2017-08-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUnderstanding the psychosocial stressors of people with psychoses from minority ethnic groups may help in the development of culturally appropriate services. This study aimed to compare psychosocial factors associated with attendance at an emergency department (ED) for six ethnic groups. Preventing crises or supporting people better in the community may decrease hospitalization and improve outcomes.MethodA cohort was created by retrospective case note analysis of people of East-Asian, South-Asian, Black-African, Black-Caribbean, White-North American and White-European origin groups attending a specialized psychiatric ED in Toronto with a diagnosis of psychosis between 2009 and 2011. The psychological or social stressors which were linked to the presentation at the ED that were documented by the attending physicians were collected for this study. Logistic regression models were constructed to analyze the odds of presenting with specific stressors.ResultsSeven hundred sixty-five clients were included in this study. Forty-four percent of the sample did not have a psychiatrist, and 53% did not have a primary care provider. Social environmental stressors were the most frequent psychosocial stressor across all six groups, followed by issues in the primary support group, occupational and housing stressors. When compared to White-North American clients, East-Asian and White-European origin clients were less likely to present with a housing stressor, while Black-African clients had decreased odds of presenting with primary support group stressor. Having a primary care provider or psychiatrist were predominantly protective factors.ConclusionIn Toronto, moving people with chronic mental health conditions out of poverty, increasing the social safety net and improving access to primary care and community based mental health services may decrease many of the stressors which contribute to ED attendance.

【 授权许可】

CC BY   
© The Author(s). 2017