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. 2025 Jun 18;18(1):106.
doi: 10.1186/s12245-025-00904-5.

Evolving trends in psychiatric emergency services in Southern China: a seven-year retrospective analysis

Cuiling Zhang #  1   2 , Suiyun Weng #  1   2 , Xiaoyu Zhang  1   3 , Songkang Liu  1   2 , Min Yu  4   5 , Miaoling Jiang  6   7
Affiliations

Evolving trends in psychiatric emergency services in Southern China: a seven-year retrospective analysis

Cuiling Zhang et al. Int J Emerg Med. .

Abstract

Background: The Affiliated Brain Hospital, Guangzhou Medical University is an important provider of psychiatric emergency services (PES) in southern China. Revealing the evolution trend of the psychiatric emergency services of this hospital can help decision-makers formulate relevant policies. However, at present, there is a lack of large-scale, long-term retrospective studies.

Methods: A retrospective analysis was conducted on patient records from the psychiatric emergency room (PER) of the Affiliated Brain Hospital, Guangzhou Medical University. Data included demographic and clinical variables were aggregated annually and described using percentages from 2018 to 2024. Chi-square and Fisher's exact test were used to confirm significance of the trends.

Results: More voluntary health-seeking behaviors, broader medical insurance coverage, more cautious use of restraint measures, and more precise diagnoses were observed from 2018 to 2024. Besides, there were an increasing number of younger, highly educated, unmarried, and unemployed visitors. We also found that the gender gap is widening and medical resources are increasingly strained. There are differences between judicial and medical personnel in making compulsory decisions. During Covid-19, the demographic and clinical variables show significant changes.

Conclusions: PES in southern China have developed to a certain extent, but they are also confronted with obstacles at the same time. These trends underscore the need for enhanced referral systems, expanded community-based psychiatric care, ethical guidelines for managing coercive measures and strengthening the response strategies for public event crises.

Keywords: China; Evolving trends; Mental health services; Psychiatric emergency services; Retrospective analysis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Affiliated Brain Hospital, Guangzhou Medical University (Approval No.: 202420). All aspects of patient confidentiality, including retrospective data handling, were rigorously addressed. Data were anonymized and de-identified prior to analysis, with access restricted to authorized researchers to ensure compliance with ethical standards (e.g., Declaration of Helsinki) and local data protection regulations. Informed consent was waived by the ethics committee due to the retrospective nature of the study and the use of anonymized patient data. Consent for publication: All the authors have reviewed and approved the final version of the manuscript. We agree to submit the manuscript to International Journal of Emergency Medicine for publication. We accept the journal’s copyright and licensing policies (e.g., transfer copyright to the publisher or publish under a Creative Commons license if applicable). Corresponding author Miaoling Jiang are authorized to communicate with the journal on behalf of all authors. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Evolving Trends and statistical differences in Demographic Characteristics of PER Visits from 2018–2024. A Gender Distribution. B Age Distribution. C Marital Status Distribution. D Occupation Status Distribution. E Education Status Distribution. F Insurance coverage Distribution. Notes: Line graph showing discrete yearly data points (solid circles) for each variable, connected by straight lines to illustrate temporal trends. Different colors line represent different variables. Each point represents the percentage value of different variables in a specific year. Significant differences between time points identified by chi-square tests are marked with asterisks: The proportion of female, adolescent patients (under 18 years old), unmarried, unemployed, highly educated (Bachelor or College degree), and those with medical insurance coverage seeking medical treatment has also risen (P < 0.001). The proportion of patients aged 45–49 seeking medical treatment has decreased (P < 0.001). During the period of 2020–2021, there were significant changes in the gender distribution, age distribution, educational attainment distribution and the proportion of medical insurance visits among emergency patients compared with 2019 (P < 0.001)
Fig. 2
Fig. 2
Evolving Trends and statistical differences in Clinical Characteristics of PER Visits from 2018–2024. A Emergency Triage Distribution. B Health-seeking Behavior and Restrictive Measures Used Distribution. C Emergency Outcomes Distribution. D Diagnostic Categories Distribution. E Escort Distribution. Notes: Line graph showing discrete yearly data points (solid circles) for each variable, connected by straight lines to illustrate temporal trends. Each point represents the percentage value of different variables in a specific year. Significant differences between time points identified by chi-square tests are marked with asterisks. The proportion of voluntary health-seeking behaviors and the low-level triage trend has increased, while proportion of the restraint measures used and the admission to the hospital have shown opposite trends (P < 0.001). The diagnoses has become more precise with less patients diagnosed as F99 (P < 0.001). Most patients were escorted by family, but came by oneself were increased (P < 0.001). During the period of 2020–2021, compared with 2019, there were significant differences in the emergency triage distribution, the usage of protective restraint, the proportion of patients seeking medical treatment voluntarily and inpatients patients, as well as the diagnoses distribution (P < 0.001)
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