Age and sex trends among mental health-related emergency department visits in North Carolina

Abstract

Whether patients present to the emergency department (ED) with physical ailments and comorbid psychiatric needs or primary psychiatric complaints, understanding differences in clinically relevant age and sex patterns over time is crucial to optimal psychiatric care in the ED setting. We used population-level surveillance data provided by the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) from January 1, 2008, through December 31, 2014. Mental health-related (MHR) ED visits were identified by International Classification of Diseases, Clinical Modification 9th revision (ICD-9-CM) codes analyzed in the Agency for Healthcare Research and Quality (AHRQ) clinical classification software groupings of related diagnostic categories. Trends were assessed based on total and average annual visit counts. We identified approximately 4 million MHR ED visits. The average number of visits per year was highest among 50-year-olds, while patients over the age of 90 had the highest proportion of their ED visits associated with an MHR code. Mood disorders were more prevalent among females, while substance use disorders were more prevalent among males. Within MHR categories, age-related peaks did not differ by sex except for suicide and self-inflicted injury. Whether it be a teenage boy presenting with suicidal ideation, a middle-aged man presenting with alcohol abuse, or an elderly female presenting with dementia, ED MHR visits’ needs vary across the lifespan. Understanding these trends is important to holistic patient care.