Abstract
Aims and MethodA substantial minority of patients attending emergency departments do so with a primary mental health problem. A number will require admission to an acute psychiatric unit. There is little guidance about the best practice in terms of risk assessment and escorting of these patients. We conducted a telephone questionnaire survey of acute trusts, to identify current policies for the transfer of patients with mental illness to acute psychiatric units.ResultsEighty-two trusts were contacted. We could not verify the presence of any current policies. There was considerable variation in the assessment and management of risk in these clinical circumstances.Clinical ImplicationsCurrent local service structure and transfer distance may influence the way in which risk is assessed. However, there is a need for trusts to ensure that basic standards of risk assessment are maintained for the transfer of these high-risk patients. We recommend that all emergency departments should have such policies and that liaison psychiatry is well placed to aid their development.
Highlights
We recommend that all emergency departments should have such policies and that liaison psychiatry is well placed to aid their development
The Council Report Psychiatric Services to Accident and Emergency Departments (Royal College of Psychiatrists, 2004) states that at least 5% of patients presenting to emergency departments do so with a primary mental health problem
The questionnaire sought information regarding the distance between the emergency department and the acute psychiatric unit; the most common method of transfer for both informal and detained patients; the likely escorts for transfer; the risks assessed prior to transfer; and the designation of individuals assessing risk
Summary
A substantial minority of patients attending emergency departments do so with a primary mental health problem. A number will require admission to an acute psychiatric unit.There is little guidance about the best practice in terms of risk assessment and escorting of these patients. We conducted a telephone questionnaire survey of acute trusts, to identify current policies for the transfer of patients with mental illness to acute psychiatric units
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