Research Output

Epidemiology of emergency ambulance service calls related to mental health problems and self harm: a national record linkage study.

  Background: People experiencing a mental health crisis receive variable and poorer quality care than those experiencing a physical health crisis. Little is known about the epidemiology, subsequent care pathways of mental health and self-harm emergencies attended by ambulance services, and subsequent all-cause mortality, including deaths by suicide. This is the first national epidemiological analysis of the processes and outcomes of people attended by an ambulance due to a mental health or self-harm emergency. The study aimed to
describe patient characteristics, volume, case-mix, outcomes and care pathways following ambulance attendance in this patient population.
Methods: A linked data study of Scottish ambulance service, emergency department, acute inpatient and death records for adults aged ≥16 for one full year following index ambulance attendance in 2011.
Results: The ambulance service attended 6802 mental health or self harm coded patients on 9014 occasions. This represents 11% of all calls attended that year. Various pathways resulted from these attendances. Most frequent were those that resulted in transportation to and discharge from the emergency department (n =
4566/9014; 51%). Some patients were left at home (n = 1003/9014 attendances, 11%). Others were admitted to hospital (n = 2043/9014, 23%). Within 12 months of initial attendance, 279 (4%) patients had died, 97 of these were recorded as suicide.
Conclusions: This unique study finds that ambulance service and emergency departments are missing opportunities to provide better care to this population and in potentially avoidable mortality, morbidity and service burden. Developing and testing interventions for this patient group in pre-hospital and emergency department settings could lead to reductions in suicide, patient distress, and service usage

  • Type:

    Article

  • Date:

    20 March 2019

  • Publication Status:

    Published

  • DOI:

    10.1186/s13049-019-0611-9

  • Library of Congress:

    RT Nursing

  • Dewey Decimal Classification:

    610.7 Medical education, research & nursing

  • Funders:

    Edinburgh Napier Funded

Citation

Duncan, E., Best, C., Dougall, N., Skar, S., Evans, J., Corfield, A., …Wojcik, W. (2019). Epidemiology of emergency ambulance service calls related to mental health problems and self harm: a national record linkage study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 27(34), https://doi.org/10.1186/s13049-019-0611-9

Authors

Keywords

Mental health, Emergency department, Pre-hospital,

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    © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
    International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

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