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. 2024 Apr 1;3(2):e189.
doi: 10.1002/pcn5.189. eCollection 2024 Jun.

Association between mental health social worker staffing in psychiatric emergency wards and readmission outcomes: A nationwide survey in Japan

Kosuke Suzuki  1   2 , Tomihisa Niitsu  1 , Hiroshi Kimura  1   2   3 , Yuta Yanagisawa  1   2 , Marina Ono  1 , Hideki Komatsu  4 , Kensuke Yoshimura  5 , Hiroyuki Watanabe  1   2   6 , Masaomi Iyo  1
Affiliations

Association between mental health social worker staffing in psychiatric emergency wards and readmission outcomes: A nationwide survey in Japan

Kosuke Suzuki et al. PCN Rep. .

Abstract

Aim: The mental healthcare system in Japan is transitioning from institution-based to community-based treatment. To prevent prolonged hospitalization and community integration of psychiatric patients, mental health social workers (MHSWs) are pivotal in coordinating post-discharge arrangements for psychiatric inpatients. This study aimed to propose a care model to improve clinical outcomes in psychiatric emergency wards in Japan.

Methods: We conducted a mail-in questionnaire survey targeting medical facilities with psychiatric emergency wards. We collected data of the psychiatric care system, including facility profiles, staffing conditions and caseloads, and the provided psychiatric services and treatment options. Using multiple regression analyses, we explored associations between these data and clinical outcomes, focusing on the average number of days for hospitalization and the integration of patients into a community.

Results: Data were collected from 82 facilities (response rate, 45.8%). The average number of days for hospitalization and community integration were 64.7 and 327.9 days, respectively. The caseloads for MHSWs were significantly associated with longer hospitalization (β = 0.31, p = 0.009) and shorter duration of community living (β = -0.28, p = 0.027).

Conclusion: The clinical performance in psychiatric emergency wards surpassed the Japanese government's targets regarding these outcomes. We found that heavy caseloads on MHSWs were associated with worse clinical outcomes for patients in psychiatric emergency wards. These findings suggest that reducing MHSW caseloads (≤20 cases) may be a potential interventional strategy to prevent prolonged hospitalization and promote successful community integration of patients.

Keywords: community transition; integration; mental health; psychiatric emergency services; psychiatric social workers.

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Conflict of interest statement

Masaomi Iyo is an Editorial Board member of Psychiatry and Clinical Neurosciences Reports and a co‐author of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scatterplot of the caseload of mental health social workers (MHSWs) in psychiatric emergency wards and average number of hospital admission days. R 2, coefficient of determination; ρ, Spearman's correlation coefficient.
Figure 2
Figure 2
Scatterplot of the caseload of mental health social workers (MHSWs) in psychiatric emergency wards and average number of days of living in the community. R 2, coefficient of determination; ρ, Spearman's correlation coefficient.
See this image and copyright information in PMC

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