Frequent Users in Psychiatric Consultations: A 6-Year Retrospective Study in the Emergency Department

Abstract

The increasing prevalence of emergency room (ER) visits for mental health concerns presents a significant challenge for healthcare systems. This study aimed to analyze the socio-demographic and clinical characteristics associated with frequent users of psychiatric consultations in the ER of Maggiore della Carità University Hospital in Novara, Italy. A retrospective observational study was conducted over a six-year period (2017-2022), including all psychiatric consultations recorded in a hospital database. Frequent users were defined as individuals undergoing at least three psychiatric consultations in the ER within a year. Univariable and multivariable logistic models were employed to identify significant socio-demographic and clinical predictors of frequent use. Of the 1565 individuals who received psychiatric consultations in the ER, 92 (5.88%) were identified as frequent users. Factors associated with higher ER utilization included being unmarried (aOR 1.35, 95% CI 1.02-1.79), younger age (aOR 1.32, 95% CI 1.02-1.72), homelessness, diagnosis of schizophrenia, substance use disorder (aOR 1.49, 95% CI 1.06-2.09), and ongoing psychopharmacological treatment (aOR 1.56, 95% CI 1.12-2.18). These findings highlight the need for targeted interventions to improve care continuity and community-based support for individuals at risk of frequent ER visits for psychiatric reasons.

Keywords: demography; emergency service; frequent users; health services misuse; hospital; mental health; psychiatric consultation; socioeconomic factors.