Characteristics and Outcomes among Adult Psychiatric Emergency Services Patients in a Large Urban Safety Net Health System
Population Characteristics: 60% of PES patients were male and 67% fell between the ages of 18-44; 63% were brought in by law enforcement, 66% were uninsured, and 9% were homeless. After PES evaluation, 52% of patients were hospitalized (public or private), 41% were discharged to home/family, and 7% were discharged to other venues (shelter, jail, etc.).
Post-Index Encounter Outcomes: 5,564 (22%) of patients made 9,501 PES visits; 4,726 had 10,881 psychiatric inpatient admissions within this period. Furthermore, within a 30-day period, 1,027 (4%) patients had made 1,823 subsequent PES ED visits and 1,330 (5%) patients had 3,853 subsequent psychiatric inpatient admissions. Additionally, in the year following their index visits, 1,558 patients (6%) had arrest records, and 573 (2%) died within one year, including 84 (0.3%) due to either homicide or suicide.
Conclusion: This pattern of high utilization and poor outcomes emphasizes the need for follow-up mental health care after discharge for PES patients arriving on involuntary holds.
Learning Areas:Social and behavioral sciences
Discuss the importance of studying patients with mental illnesses who are in danger of harming themselves or others
Keyword(s): Emergency Medical Services, Mental Health Treatment &Care
Qualified on the content I am responsible for because: I have a Ph.D. in Experimental Psychology and oversee the Analytical Services in the Office of Planning and Data Analytics for Department of Health Services (DHS)in Los Angeles County. In that capacity, I am responsible for understanding the pattern of utilization and outcomes for persons with mental illnesses who receive psychiatric emergency services through an involuntary hold at our 3 hospitals.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.