The staff in the emergency psychiatric services (EPS) serve as gatekeepers to hospitalization, first line of care in crisis, and sole providers for some disadvantaged individuals in the community. Their jobs have become more pressured and dangerous as utilization of EPS has soared and resources constrained. Contributing to the soaring rate are the individuals who disproportionately rely on the EPS (i.e., frequent utilizers). In this study we surveyed the staff at a large (10,000+ admissions per year) urban EPS on their perception of reasons motivating frequent and infrequent EPS utilization. The anonymous survey listed 24 possible reasons that were then collapsed to 10 categories. The participation rate was 75% for the staff of 48. The reasons endorsed by greater than 75% of the staff for frequent utilizers were: difficulty accessing alternative services (94%), substance abuse (92%), basic needs (92%), wanting inpatient admission (86%), noncompliance with treatment plan (81%), and psychosocial problems (81%). For infrequent utilizers, the categories with the highest percentage of endorsement were psychosocial problems (69%) and symptoms/medical problems (67%). No major differences by shift or disciplines were noted. These results suggest that there is consensus on perceived reasons for frequent utilization that emphasize basic social burdens and difficulty in accessing alternative services. The consensus, furthermore, cuts across shifts and disciplines. Research needs to confirm those beliefs, but provider-based interventions that do not address those concerns will more likely face staff obstacles in implementation.
Learning Objectives: At the conclusion of the session, the participant will be able to list staff's perception of reasons motivating frequent emergency psychiatric service utilization and discuss the importance of knowing staff's perception.
Keywords: Homeless, Mental Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.