Comparison of two models for delivery of services in psychiatric emergencies

Abstract

Objective To evaluate the benefits of the psychiatric emergency service (PES) model, in comparison to the model of the psychiatric consultant to the emergency department (the consultation model). Methods A retrospective chart review of 100 involuntary PES patients and 100 involuntary patients of the consultation model were matched for age, sex, ethnicity and primary diagnosis. Baseline characteristics, demographics and various outcomes of the two groups were compared. Results After establishment of the psychiatric emergency service, there were improvements in the following categories: (1) timely rendering of psychiatric emergency care (330 vs. 639 min, P<.01), (2) completion of mental status exam (95% vs. 49%, P<.01), (3) pregnancy testing (73% vs. 52%, P<.05), (4) safety in the form of seclusion (6% vs. 15%, P<.05) and elopement (5% vs. 13%, P<.05). There were no statistical significant differences in urine toxicology ordered, follow-up care provided and readmission rate after 30 days. Conclusion The PES is a multidisciplinary system that can be beneficial to psychiatric emergency patients by providing timely rendering of care, improving access to care, and ensuring safety and better assessment.