Psychiatric Emergencies in the Community: Characteristics and Outcome in Switzerland

Autor: Florian Hotzy, Anastasia Theodoridou, Jan Roehmer, Raphael Heinrich, Anke Maatz, Sonja Moetteli, Matthias Jaeger, Erich Seifritz, Camillo Amodio
Přispěvatelé: University of Zurich, Hotzy, Florian
Rok vydání: 2021
Předmět:
medicine.medical_specialty
2921 Psychiatric Mental Health
Coercion
medicine.medical_treatment
Crisis intervention
610 Medicine & health
Logistic regression
Health informatics
Health administration
2738 Psychiatry and Mental Health
Psychiatric emergencies
medicine
Humans
Referral and Consultation
Retrospective Studies
business.industry
Aggression
Health Policy
Public health
Medical record
Environmental and Occupational Health
Community services
Involuntary admission
Public Health
Environmental and Occupational Health
2739 Public Health
Environmental and Occupational Health
Hospital admission
2719 Health Policy
Psychiatry and Mental health
Psychotic Disorders
10054 Clinic for Psychiatry
Psychotherapy
and Psychosomatics
Family medicine
Original Article
Public Health
Emergencies
Pshychiatric Mental Health
medicine.symptom
business
Switzerland
Zdroj: Administration and Policy in Mental Health
ISSN: 1573-3289
0894-587X
Popis: Psychiatric emergencies occur frequently in the community setting, e.g. the patient’s home or public places. Little is known about the characteristics and outcome of these situations. This study describes psychiatric emergencies in the canton of Zurich, Switzerland, and examines determinants of their outcome. We retrospectively analyzed 620 medical records of consultations classified as psychiatric emergencies of a 24/7 service of community-based emergency physicians. Information on sociodemographic, clinical and situational factors was extracted. The observation period was 6 months in 2017. Binary logistic regression was used to examine predictors for involuntary admissions. Most emergency consultations (64.5%) took place at the patient’s home, followed by police stations (31.0%), public places (3.2%), and somatic hospitals (1.3%). Patient characteristics and reasons for consultation varied considerably between the locations. The first involved person was commonly a relative. Of all consultations, 38.4% resulted in involuntary admissions, mainly in patients with psychosis, suicidality, aggression, refusal of necessary treatment and previous involuntary admissions. Situation-related factors and the involvement of relatives were no significant predictors of the outcome. Psychiatric emergencies occur in different places and in patients with a variety of psychiatric symptoms. Although half of the emergency situations were resolved in the community, the rate of involuntary admissions was still high. For additional reduction, the further development of quickly available alternatives to psychiatric inpatient treatment is required. These should be specifically geared towards acute situations in patients with the described risk factors. Additionally, the role of relatives during psychiatric emergencies should be further studied.
Databáze: OpenAIRE
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