Characteristics of patients completing referrals from an emergency department to a psychiatric outpatient clinic

Abstract

Many patients referred from emergency departments for psychiatric outpatient treatment fail to make contact with the facilities to which they have been referred. 1–4 Completion rates in the range of 7.1%–63% have been typically reported. 2,3,5 While diverse explanations such as the method of referral 3 and characteristics of facilities 1 have been suggested as determinants of the low completion rate, research has focused largely on demographic characteristics of the patients referred. 3,5,6 For example, patient's sex, 2,5 socioeconomic status, 1 race, 5 and age 2,3 have been found to relate to the completion of referrals made in the emergency department. While the clinical characteristics of psychiatric emergency department patients have received some attention, studies have focused more on describing these patients 6–9 than on investigating the relationship between their characteristics and successful completion of referrals. Furthermore, studies which have attempted to relate clinical characteristics to completion rates, 2,4,10 along with those focusing on demographic characteristics, have tended to overlook the question of whether patients who failed to complete their referrals to a particular facility actually made contact with some other psychiatric facility. The purposes of the present study are (1) to investigate both the demographic and clinical characteristics of patients who successfully complete referrals from a psychiatric emergency department to a psychiatric outpatient clinic and (2) to determine by means of a thorough follow-up the characteristics of patients who failed to complete the referral but sought treatment elsewhere in the community.