Characteristics and outcome of patients transported by police to emergency departments under section 351 of the Mental Health Act 2014 (Vic)

Author(s):  
Beth Ward ◽  
Jason Kollios ◽  
Fiona Smith ◽  
Sharon Klim ◽  
Ainslie Senz ◽  
...  
BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S321-S321
Author(s):  
Sacha Evans

AimsThe aim of this project was to look at whether the COVID-19 pandemic, specifically lockdown, has impacted out-of-hours presentations to Child and Adolescent Mental Health Services (CAMHS) in North Central and East London.MethodSpecialist Registrars (SpRs) on the Royal London/Great Ormond Street CAMHS Higher Training Scheme are contacted for advice regarding all CAMHS presentations in the North Central and East London area. Responsibilities includes provision of advice to 6 hospitals (including 4 emergency departments) and 4 child and adolescent inpatient units. A record of all phone calls and call-outs, including Mental Health Act and Section 136 (S136) assessments are maintained and this study compares pre- and post-COVID-19 data to see if there are any differences in number of presentations, on-site assessments (including Mental Health Act and S136 assessments over 2019 and 2020.ResultNumbers of CAMHS presentations were lower in 2020 (mean 74 patients per month) compared with 2019 (60 patients per month). This was consistent across all months except October and December. The largest difference was seen in March: 109 patients presented in March 2019, compared with 55 in March 2020. This is also reflected in the number of assessments conducted on site. However, there do not appear to be differences in the numbers of Mental Health Act or S136 assessments undertaken over 2020, compared with 2019.ConclusionCAMHS out-of-hours presentations dropped off significantly at the start of the COVID-19 pandemic in the UK, and in particular, with the first lockdown (March to July 2020). Specialist Registrars provided advice via telephone less frequently in 2020 compared with 2019, and were required to do fewer on-site assessments of children and young people presenting with mental health difficulties.There were no significant differences in Mental Health Act or S136 assessments between the two years, however, these numbers are too small to make any meaningful conclusions.It is likely that children and adolescents were less likely to present to emergency departments for assessment of their mental health difficulties during the COVID-19 pandemic, rather than this reflecting a true reduction in mental health difficulties.Recommendations:It is helpful to continue to monitor CAMHS out-of-hour presentations.Trusts may want to consider alternative settings for providing emergency CAMHS assessments, for example, mental health hubs.Limitations:This provision of data is subject to recall bias.


It is common for patients with mental health problems to present to emergency and urgent care services at times of crisis. Patients with acute distress, agitation, or psychosis can be very difficult to manage in the acute phase of their illness. Emergency departments often have the support of mental health liaison nurses. However, nursing staff still require skills in assessment that enable them to rapidly identify patients with acute problems that may pose a risk to themselves or others. This chapter covers the assessment and management of common mental health emergencies and includes relevant sections within the Mental Health Act.


Author(s):  
Rachel Churchill ◽  
Sharon Wall ◽  
Matthew Hotopf ◽  
Alec Buchanan ◽  
Simon Wessely

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