Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy

<p>Australia, like many other countries that adopted deinstitutionalisation is experiencing increased presentation at emergency departments (EDs) by patients with acute mental health and addiction needs. While different models of psychiatric emergency care have been utilised within EDs little is known about the effectiveness of the care provided or how they work on a day-to-day basis. Psychiatric Emergency Care Centres (PECCs) is one of these new initiatives. PECCs aim to improve patient flow in urban EDs by providing a rapid pathway to specialist mental health assessment and care. St Vincent hospital in Sydney opened a 6 bed PECC service in 2005. It is co-located with ED and staffed 24 hours a day by registered mental health nurses supported by psychiatric and emergency teams. The service has two components - a short term stay unit and an ED liaison role. The nurses work closely with community mental health teams, inpatient units, general practitioners, non-government agencies and other hospitals. This thesis evaluated the organisational and operational aspects of this PECC service using a processimpact evaluation. Documents, existing clinical records and interviews with nurses in the PECC and ED and with a consumer representative were used as data sources to describe the service and identify what was working well and what could be improved. The research found that the service has provided additional resources and collaboration between ED and mental health services. In addition the research found that PECC is an effective service catering to the needs of consumers and providing access to mental health specialist clinicians. Since PECC was established there has been an increase in assessments conducted within the ED and an increase in the numbers presenting to ED for mental health reasons from 2833 in 2006 to 4987 in 2008, but the number of admissions to PECC have remained relatively stable at 693 and 714. Aspects of the service that worked well included the rapid assessment and management of acutely unwell people by the PECC nurses. Aspects that were problematic concerned the ability of the service to address social issues and the management of people with behavioural, alcohol, substance intoxication or selfharm behaviours. Areas for enhancing the service include being more consumers responsive, increasing the skills and knowledge of staff and undertaking further research regarding the needs of people who use the service.</p>

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St. Vincent's Psychiatric Emergency Care Centre: an Evaluation of a Nurse-Led Service

10.26686/wgtn.16968322 ◽

2021 ◽

Author(s):

◽

Caroline H Koia

Keyword(s):

Mental Health ◽

Emergency Care ◽

Social Issues ◽

Patient Flow ◽

Rapid Assessment ◽

Health Assessment ◽

Psychiatric Emergency ◽

Mental Health Nurses ◽

Mental Health Assessment ◽

Clinical Records

<p>Australia, like many other countries that adopted deinstitutionalisation is experiencing increased presentation at emergency departments (EDs) by patients with acute mental health and addiction needs. While different models of psychiatric emergency care have been utilised within EDs little is known about the effectiveness of the care provided or how they work on a day-to-day basis. Psychiatric Emergency Care Centres (PECCs) is one of these new initiatives. PECCs aim to improve patient flow in urban EDs by providing a rapid pathway to specialist mental health assessment and care. St Vincent hospital in Sydney opened a 6 bed PECC service in 2005. It is co-located with ED and staffed 24 hours a day by registered mental health nurses supported by psychiatric and emergency teams. The service has two components - a short term stay unit and an ED liaison role. The nurses work closely with community mental health teams, inpatient units, general practitioners, non-government agencies and other hospitals. This thesis evaluated the organisational and operational aspects of this PECC service using a processimpact evaluation. Documents, existing clinical records and interviews with nurses in the PECC and ED and with a consumer representative were used as data sources to describe the service and identify what was working well and what could be improved. The research found that the service has provided additional resources and collaboration between ED and mental health services. In addition the research found that PECC is an effective service catering to the needs of consumers and providing access to mental health specialist clinicians. Since PECC was established there has been an increase in assessments conducted within the ED and an increase in the numbers presenting to ED for mental health reasons from 2833 in 2006 to 4987 in 2008, but the number of admissions to PECC have remained relatively stable at 693 and 714. Aspects of the service that worked well included the rapid assessment and management of acutely unwell people by the PECC nurses. Aspects that were problematic concerned the ability of the service to address social issues and the management of people with behavioural, alcohol, substance intoxication or selfharm behaviours. Areas for enhancing the service include being more consumers responsive, increasing the skills and knowledge of staff and undertaking further research regarding the needs of people who use the service.</p>

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A comparison between two community-based mental health services, Northern Italy and Northern Norway

Psychiatrische Praxis ◽

10.1055/s-0031-1277917 ◽

2011 ◽

Vol 38 (S 01) ◽

Author(s):

D Pucci ◽

F Amaddeo ◽

A Rossi ◽

G Rezvy ◽

R Olstad ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Northern Italy ◽

Community Based ◽

Northern Norway

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Heterogeneity of reasons for attendance in frequent attenders of emergency departments and its relationship to future attendance

Emergency Medicine Journal ◽

10.1136/emermed-2020-210412 ◽

2021 ◽

pp. emermed-2020-210412

Author(s):

Richard Hotham ◽

Colin O'Keeffe ◽

Tony Stone ◽

Suzanne M Mason ◽

Christopher Burton

Keyword(s):

Mental Health ◽

Mental Disorder ◽

Emergency Care ◽

Health Problem ◽

Patient Characteristics ◽

Health Needs ◽

Data Set ◽

Frequent Attenders ◽

History Of ◽

Ed Visits

BackgroundEDs globally are under increasing pressure through rising demand. Frequent attenders are known to have complex health needs and use a disproportionate amount of resources. We hypothesised that heterogeneity of patients’ reason for attendance would be associated with multimorbidity and increasing age, and predict future attendance.MethodWe analysed an anonymised dataset of all ED visits over the course of 2014 in Yorkshire, UK. We identified 15 986 patients who had five or more ED encounters at any ED in the calendar year. Presenting complaint was categorised into one of 14 categories based on the Emergency Care Data Set (ECDS). We calculated measures of heterogeneity (count of ECDs categories and entropy of categories) and examined their relationship to total number of ED visits and to patient characteristics. We examined the predictive value of these and other features on future attendance.ResultsMost frequent attenders had more than one presenting complaint type. Heterogeneity increased with number of attendances, but heterogeneity adjusted for number of attendances did not vary substantially with age or sex. Heterogeneity was associated with the presence of one or more contacts for a mental health problem. For a given number of attendances, prior mental health contact but not heterogeneity was associated with further attendance.ConclusionsHeterogeneity of presenting complaint can be quantified and analysed for ED use: it is increased where there is a history of mental disorder but not with age. This suggests it reflects more than the number of medical conditions.

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