Treatment and follow-up in the psychiatric emergency room can be improved

Abstract

Introduction: The first and perhaps only contact many patients have with the psychiatric hospital system is at the psychiatric emergency room (PER). A growing load on the wards has raised the threshold for admission. Thus, it is important to make plans for patients who are seen in the PER, but are not hospitalised. The objective of this study was to investigate what treatment, plans and follow-up patients receive in the PER when they are not admitted.

Material and methods: This is a review of 100 consecutive PER patient reports from 2012 on patients who were seen by a doctor and not admitted at the Psychiatric Centre Frederiksberg, Denmark. The following issues were investigated: diagnosis, which medical and/or psychotherapeutic treatment was given or recommended, social interventions, objective findings, plans for treatment and referrals, and whether relevant referral was neglected.

Results: A total of 29 patients started psychopharmacological treatment, but only four received a plan for further treatment. Eleven received psychotherapy. Nine received social intervention. A total of 97 were discharged with follow-up. In 14 cases, relevant referral may have been neglected. Eleven reports lacked a description of psychiatrically objective findings, 20 lacked evaluation of suicidality.

Conclusion: Doctors in the PER are vigilant to ensure plans for follow-up. However, these plans may sometimes be deficient. Doctors in the PER often use medical approaches to relieve patients' symptoms, but there is a need for a plan for how these treatments should be followed up. Furthermore, there seems to be a need for a stronger focus on psychotherapy and social intervention.

Funding: not relevant.

Trial registration: not relevant.