Abstract
A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months. Forty per cent presented with deliberate self-harm and 25% of these left before being assessed. Twenty per cent of those with problems compatible with a diagnosis of severe mental illness also left before being seen by a doctor. Differences between presentations ‘out-of-hours' and ‘in-hours' are described. Factors predicting admission were: previous psychiatric admission, symptoms of a psychotic or affective disorder and non-permanent accommodation. The survey has implications for the process of triage in A&E departments and the organisation of mental health liaison services.
Highlights
A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months
This is a nationally agreed coding designed to reflect the urgency of the presenta tion (PI, life-threatening problem to be seen within 15 minutes: P2, urgent but not lifethreatening problem to be seen within 1 hour; P3. non-urgent case to be seen within 2 hours; and P4, to be seen within 4 hours)
The assessment of acutely presenting psychiatric illness takes place in a general hospital A&E department. The management of such cases has been severely affected by the closure of A&E departments, which has resulted in remaining A&E depart ments being overloaded and waiting times lengthening, and the closure of acute psychiatric beds, which has led to demand exceeding supply and bed occupancy rates above 100% (Hollander & Slater, 1994)
Summary
A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months. A&E nurse who assigns a triage code ranging from PI to P4 This is a nationally agreed coding designed to reflect the urgency of the presenta tion The Patient's Charter states that people attend winigll a"cbceidseenent aimndmeedmiaetreglyen"caynd(Ah&avEe)d"ethpeairrtmneenetd for treatment assessed". This includes the 'im mediate admission' of people with acute psychia tric illness, which has been identified as one of the core services in the National Health Service. The assessment of acutely presenting psychiatric illness takes place in a general hospital A&E department. Every person presenting to A&E has a casualty incident card completed and is triaged by an
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