Factors associated with emergency department service outcomes for people with a mental health problem brought in by police: a retrospective cohort study
Rachel Wardrop
A B * , Jamie Ranse A B C , Wendy Chaboyer A B , Jesse T. Young D E F G , Stuart A. Kinner E H I J and Julia Crilly A B C
A School of Nursing and Midwifery, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
B Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
C Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, Qld 4215, Australia.
D Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic., Australia.
E Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, Vic., Australia.
F School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.
G National Drug Research Institute, Curtin University, Perth, WA, Australia.
H School of Population Health, Curtin University, Perth, WA, Australia.
I Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic., Australia.
J Griffith Criminology Institute, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
Australian Health Review 47(4) 448-455 https://doi.org/10.1071/AH22229
Submitted: 10 October 2022 Accepted: 26 April 2023 Published: 15 May 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objective This study aimed to identify factors associated with an emergency department (ED) length of stay ≥4 hours (h) and hospital admission for people with a mental health problem brought in by police.
Methods We undertook a retrospective, observational cohort study of state-wide adult ED mental health presentations brought in by police from 1 January 2012 to 31 December 2017. We used multivariable logistic regression to determine factors associated with an ED length of stay ≥4 h and hospital admission.
Results In total, 9325 ED presentations with a mental health problem brought in by police to Queensland EDs were included. Factors most strongly associated with an ED length of stay ≥4 h included an Australasian Triage Score (ATS) of 1, an age of 85 years or older, night shift arrival and subsequent hospital admission. For hospital admission, an ATS of 1, an age of 85 years or older and an ED length of stay ≥4 h were the strongest factors.
Conclusion Findings indicate opportunities for targeted mental health models of care to better support people brought in by police to an ED. Such models should involve ED, pre-hospital providers (police and ambulance) and mental health services to support early intervention and potentially reduce the likelihood of a long ED length of stay and subsequent hospital admission.
Keywords: ambulance, emergency department, hospital admission, length of stay, mental health, observational study, outcomes, police.
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