Utilization of emergency departments for psychiatric treatment.

Introduction The increasing use of the general hospital emergency department (E.D.) for all kinds of health problems has been well documented. A variety of recent surveys in Canada and the United States estimate that emergency room visits are mushrooming at a rate of between 10 and 30% per year, with non-urgent problems making up an increasing proportion of the total caseload (3,7,8,12,19). Many emotionally disturbed persons need, or they or their families or anyone of a number of helping professionals believe they need immediate psychiatric attention. It has been suspected by many emergency room physicians, that such potential psychiatric problems are contributing to the increasing E.D. caseload and that in spite of the development of alternate mental health facilities, trust in the conventional, medical mode of treatment persists, and is responsible for the increasing readiness with which patients resort to E.D.'s during times of emotional crisis. If these suspicions are true, then it can beappreciated that modem E.D.'s should function as a portal of entry into the mental health care system and as such should be an ideal site for the application of the principles of community mental health (4). The present study was initiated in 1975, by a request from Edmonton civic officials to the Local Board of Health to provide data regarding the utilization of local emergency departments by emotionally disturbed persons.