2024 15th Annual NUBE Conference

Background
Recent research has found that visits to the Emergency Department (ED) for mental health and substance use disorders are increasing in British Columbia, Canada (Lavergne et al., 2022). As a result, EDs need to effectively manage and respond to the influx of mental health visits. Proper mental health screening, effective triage, and consistent follow-up communication have been identified as crucial factors in improving patient care for those visiting due to mental health reasons (Vasiliadis et al., 2015; Opoku et al., 2018). However, a gap in the literature exists for investigating and understanding the metrics mentioned above in the Interior region of British Columbia, Canada.
Methods
To evaluate descriptive statistics related to suicide screening, the triage process, and follow-up care, a randomized retrospective patient chart audit was conducted. The health authority randomly pulled patient charts identified as mental health and/or problematic substance use from 9 EDs in the Interior of BC, Canada. The audit included patients of any age who visited an ED with a primary concern related to mental health and/or substance use during the six-month study period from January to June of 2023. Study measures included (1) completion rates of the Columbia Suicide Severity Rating Scale (2) patient wait times and rates of admission, discharge, and transfer, and (3) rates of post-discharge follow-up communication.
Results
1505 patient visits were audited, which represents 30% of the total mental health and substance use visits during the study period. Statistical analysis identified that only 3% of suicidal patients had been administered the suicide screener and that the average wait time for mental health crises was significantly longer than for physical crises. Only 25% of those with suicidal ideation received follow-up communication after being discharged.
Conclusions
Patient care for those presenting to EDs for mental health reasons must be significantly improved. Findings underscore a need to improve the consistency of suicide screening for those presenting with mental health crises and move towards standardizing follow-up communication.

Learning Objectives:

To better understand what care looks like for those visiting an ED for mental health reasons

To highlight current struggles in providing evidence-based care to those visiting the ED for mental health reasons

To understand how our EDs are ill equipped for the growing number of patients presenting with mental health crises