Karim Al-Khafaji1, John Loy1, Anne-Maree Kelly2. 1. (Formerly) Department of Emergency Medicine, Western Health, Australia. 2. Joseph Epstein Centre for Emergency Medicine Research at Western Health, Australia; The University of Melbourne, Australia. Electronic address: anne-maree.kelly@wh.org.au.
Abstract
OBJECTIVE: The aim of this study is to describe the characteristics and outcome of patients brought to an emergency department by police under Section 10 of Mental Health Act (Victoria, Australia). METHODS: Retrospective medical record review. Patients referred under Section 10 provisions treated in calendar year 2009 were identified from ED database. Data collected included demographics, incident details, patient management, final diagnosis and disposition. Primary outcomes of interest were ED diagnosis and disposition. Secondary outcomes were length of stay in ED and use of restraint or sedation. RESULTS: One hundred and ninety seven presentations by 164 patients were identified. Patients were predominantly male (58%) with median age of 35 years (IQR 22-44, range 16-69). The most common presenting complaint (65%) was threat of self harm. No sedation or restraint was used in 61%. Sixty seven percent were deemed safe for discharge home while 26% were admitted to a psychiatric ward (equally divided between voluntary and involuntary admission). The predominant discharge diagnosis was self harm ideation or intent (35%). Median ED length of stay was 156 min (inter-quartile range 79-416). CONCLUSION: Most patients brought to ED by police under Section 10 provisions were for threat of self harm and did not require sedation or restraint. The majority are discharged home. Further work exploring less restrictive or traumatic processes to facilitate psychiatric assessment of this group of patients is warranted.
OBJECTIVE: The aim of this study is to describe the characteristics and outcome of patients brought to an emergency department by police under Section 10 of Mental Health Act (Victoria, Australia). METHODS: Retrospective medical record review. Patients referred under Section 10 provisions treated in calendar year 2009 were identified from ED database. Data collected included demographics, incident details, patient management, final diagnosis and disposition. Primary outcomes of interest were ED diagnosis and disposition. Secondary outcomes were length of stay in ED and use of restraint or sedation. RESULTS: One hundred and ninety seven presentations by 164 patients were identified. Patients were predominantly male (58%) with median age of 35 years (IQR 22-44, range 16-69). The most common presenting complaint (65%) was threat of self harm. No sedation or restraint was used in 61%. Sixty seven percent were deemed safe for discharge home while 26% were admitted to a psychiatric ward (equally divided between voluntary and involuntary admission). The predominant discharge diagnosis was self harm ideation or intent (35%). Median ED length of stay was 156 min (inter-quartile range 79-416). CONCLUSION: Most patients brought to ED by police under Section 10 provisions were for threat of self harm and did not require sedation or restraint. The majority are discharged home. Further work exploring less restrictive or traumatic processes to facilitate psychiatric assessment of this group of patients is warranted.
Authors: Helen Barratt; Antonio Rojas-García; Katherine Clarke; Anna Moore; Craig Whittington; Sarah Stockton; James Thomas; Stephen Pilling; Rosalind Raine Journal: PLoS One Date: 2016-04-27 Impact factor: 3.240