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Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice
Author(s) -
Daniel Catherine,
Mukaro Violet,
Yap Celene Y. L.,
C Knott Jonathan,
Kelly Peter,
Innes Andrew,
Braitberg George,
Gerdtz Marie
Publication year - 2021
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12779
Subject(s) - psychological intervention , triage , medicine , observational study , mental health , emergency medicine , intensive care unit , cohort study , cohort , psychiatry
Behavioural assessment units (BAU) have been established in emergency departments (EDs) to provide short‐term observation, treatment, and care to people experiencing acute behavioural disturbance. A prospective observational study was conducted in a cohort of adult patients admitted to one BAU located within an ED (July–December 2017) to compare clinical characteristics, treatment outcomes, and use of restrictive interventions for those who received a specialist mental health (MH) assessment with those who did not. Of the 457 patients, 61.5% received a specialist MH assessment. This group had a lower acuity (Australasian Triage Score 10.4%; CI 0.2–2.0% vs 13.6%; CI 9.3–19.5%); more arrived with police (28.8%; CI 23.8–34.3 vs 5.1%; CI 2.7–9.4%); and were subjected to restrictive interventions while in the BAU. Security responses for unarmed threat (code grey) were higher (10.9%; CI 7.8–15.0% vs 4.4%; CI 2.3–8.5%), as was the use of chemical restraint (4.2%; CI 2.4–7.2 vs 0.0% CI 0.0 – 2.1%). Those requiring specialist MH assessment had a longer length of stay (12.7 vs 5.2 hours). Further development of the BAU model of care must include targeted, evidence‐based strategies to minimize the use of restrictive interventions and ensure timely access to acute mental health services.