How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study

<p>Abstract</p> <p>Background</p> <p>Low-threshold and out-of-hours services play an important role in the emergency care for people with mental illness. In Norway casualty clinic doctors are responsible for a substantial share of acute referrals to psychiatric wards. T...

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Main Authors: Johansen Ingrid H, Morken Tone, Hunskaar Steinar
Format: Article
Language:English
Published: BMC 2012-04-01
Series:International Journal of Mental Health Systems
Subjects:
Online Access:http://www.ijmhs.com/content/6/1/3
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author Johansen Ingrid H
Morken Tone
Hunskaar Steinar
author_facet Johansen Ingrid H
Morken Tone
Hunskaar Steinar
author_sort Johansen Ingrid H
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Low-threshold and out-of-hours services play an important role in the emergency care for people with mental illness. In Norway casualty clinic doctors are responsible for a substantial share of acute referrals to psychiatric wards. This study’s aim was to identify patients contacting the casualty clinic for mental illness related problems and study interventions and diagnoses.</p> <p>Methods</p> <p>At four Norwegian casualty clinics information on treatment, diagnoses and referral were retrieved from the medical records of patients judged by doctors to present problems related to mental illness including substance misuse. Also, routine information and relation to mental illness were gathered for all consecutive contacts to the casualty clinics.</p> <p>Results</p> <p>In the initial contacts to the casualty clinics (n = 28527) a relation to mental illness was reported in 2.5% of contacts, whereas the corresponding proportion in the doctor registered consultations, home-visits and emergency call-outs (n = 9487) was 9.3%. Compared to other contacts, mental illness contacts were relatively more urgent and more frequent during night time. Common interventions were advice from a nurse, laboratory testing, prescriptions and minor surgical treatment. A third of patients in contact with doctors were referred to in-patient treatment, mostly non-psychiatric wards. Many patients were not given diagnoses signalling mental problems. When police was involved, they often presented the patient for examination.</p> <p>Conclusions</p> <p>Most mental illness related contacts are managed in Norwegian casualty clinics without referral to in-patient care. The patients benefit from a wide range of interventions, of which psychiatric admission is only one.</p>
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spelling doaj.art-459a298513904b44be0f2141fca83ca92022-12-22T00:11:08ZengBMCInternational Journal of Mental Health Systems1752-44582012-04-0161310.1186/1752-4458-6-3How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational studyJohansen Ingrid HMorken ToneHunskaar Steinar<p>Abstract</p> <p>Background</p> <p>Low-threshold and out-of-hours services play an important role in the emergency care for people with mental illness. In Norway casualty clinic doctors are responsible for a substantial share of acute referrals to psychiatric wards. This study’s aim was to identify patients contacting the casualty clinic for mental illness related problems and study interventions and diagnoses.</p> <p>Methods</p> <p>At four Norwegian casualty clinics information on treatment, diagnoses and referral were retrieved from the medical records of patients judged by doctors to present problems related to mental illness including substance misuse. Also, routine information and relation to mental illness were gathered for all consecutive contacts to the casualty clinics.</p> <p>Results</p> <p>In the initial contacts to the casualty clinics (n = 28527) a relation to mental illness was reported in 2.5% of contacts, whereas the corresponding proportion in the doctor registered consultations, home-visits and emergency call-outs (n = 9487) was 9.3%. Compared to other contacts, mental illness contacts were relatively more urgent and more frequent during night time. Common interventions were advice from a nurse, laboratory testing, prescriptions and minor surgical treatment. A third of patients in contact with doctors were referred to in-patient treatment, mostly non-psychiatric wards. Many patients were not given diagnoses signalling mental problems. When police was involved, they often presented the patient for examination.</p> <p>Conclusions</p> <p>Most mental illness related contacts are managed in Norwegian casualty clinics without referral to in-patient care. The patients benefit from a wide range of interventions, of which psychiatric admission is only one.</p>http://www.ijmhs.com/content/6/1/3After-hours careMental health servicesEmergency medical servicesPrimary healthcareCoercion
spellingShingle Johansen Ingrid H
Morken Tone
Hunskaar Steinar
How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
International Journal of Mental Health Systems
After-hours care
Mental health services
Emergency medical services
Primary healthcare
Coercion
title How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
title_full How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
title_fullStr How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
title_full_unstemmed How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
title_short How Norwegian casualty clinics handle contacts related to mental illness: A prospective observational study
title_sort how norwegian casualty clinics handle contacts related to mental illness a prospective observational study
topic After-hours care
Mental health services
Emergency medical services
Primary healthcare
Coercion
url http://www.ijmhs.com/content/6/1/3
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AT hunskaarsteinar hownorwegiancasualtyclinicshandlecontactsrelatedtomentalillnessaprospectiveobservationalstudy