Abstract
Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.
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References
Gerson S, Bassuk E. Psychiatric emergencies: an overview.American Journal of Psychiatry. 1980;137:1–11.
Schwartz DA, Weiss AT, Miner JM. Community psychiatry and emergency service.American Journal of Psychiatry. 1972;129:710–715.
Ellison JM, Blum N, Barsky AJ. Repeat visitors in the psychiatric emergency service: a critical review of the data.Hospital and Community Psychiatry. 1986;37:37–41.
Bassuk E, Gerson S. Chronic crisis patients: a discrete clinical group.American Journal of Psychiatry. 1980;137:1513–1517.
Slaby AE, Perry PL. Use and abuse of psychiatric emergency services.International Journal of Psychiatry in Medicine. 1980;10:1–8.
Purdie FRJ, Honigman B, Rosen P. The chronic emergency department patient.Annals of Emergency Medicine. 1981;10:298–301.
Munves PI, Trimboli F, North AJ. A study of repeat visits to a psychiatric emergency room.Hospital and Community Psychiatry. 1983;34:634–638.
Ellison JM, Blum NR, Barsky AJ. Frequent repeaters in a psychiatric emergency service.Hospital and Community Psychiatry. 1989;40:958–960.
Hansen TE, Elliott KD. Frequent psychiatric visitors to a Veterans Affairs medical center emergency care unit.Hospital and Community Psychiatry. 1993;44:372–375.
Klinkenberg WD, Calsyn RJ. The moderating effects of race on return visits to the psychiatric emergency room.Psychiatric Services. 1997;48:942–945.
Spooren DJ, de Bacquer D, van Heeringen K, et al. Repeated psychiatric referrals to Belgian emergency departments: a survival analysis of the time interval between first and second episodes.European Journal of Emergency Medicine. 1997;4:61–67.
Dhossche DM, Ghani SO. A study on recidivism in the psychiatric emergency room.Annals of Clinical Psychiatry. 1998;10:59–67.
Saarento O, Hakko H, Joukamaa M. Repeated use of psychiatric emergency out-patient services among new patients: a 3-year follow-up study.Acta Psychiatric Scandinavica. 1998;98:276–282.
Shaner A, Eckman TA, Roberts LJ, et al. Disability income, cocaine use, and repeated hospitalization among schizophrenic cocaine abusers—a government-sponsored revolving door?New England Journal of Medicine. 1995;333:777–783.
Grossman LS, Willer JK, Miller NS, et al. Temporal patterns of veterans' psychiatric service utilization, disability payments, and cocaine use.Journal of Psychoactive Drugs. 1997;29:285–290.
Satel SL. When disability benefits make patients sicker.New England Journal of Medicine. 1995;333:794–796.
Diehl AK, Morris MD, Mannis SA. Use of calendar and weather data to predict walk-in attendance.Southern Medical Journal. 1981;74:709–712.
Holleman DR, Bowling RL, Gathy C. Predicting daily visits to a walk-in clinic and emergency department using calendar and weather data.Journal of General Internal Medicine. 1996;11:237–239.
Lieber AL. Human aggression and the lunar synodic cycle.Journal of Clinical Psychiatry. 1978;39:385–392.
Thompson DA, Adams SL. The full moon and ED patient volumes: unearthing a myth.American Journal of Emergency Medicine. 1996;14:161–164.
Byrnes G, Kelly IW. Crisis calls and lunar cycles: a twenty-year review.Psychological Reports. 1992;71:779–785.
United States 2000 Census. www.census.gov/dmd/www/2khome.htm. Accessed June 1, 2001.
Aickin M, Gensler H. Adjusting for multiple testing when reporting research results: the Bonferroni vs Holm methods.American Journal of Public Health. 1996;86:726–728.
Farmer's Almanac. http://www.farmersalmanac.com/weather/weather.html. Accessed September 26, 2001.
Allen MH. Level 1 psychiatric emergency services.The Psychiatric Clinics of North America. 1999;22:713–734.
Schein EH.Organizational Culture and Leadership. 2nd ed. San Francisco: Jossey-Bass; 1992.
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Arfken, C.L., Zeman, L.L., Yeager, L. et al. Frequent visitors to psychiatric emergency services: Staff attitudes and temporal patterns. The Journal of Behavioral Health Services & Research 29, 490–496 (2002). https://doi.org/10.1007/BF02287355
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DOI: https://doi.org/10.1007/BF02287355