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Mental health triage in the ER: a qualitative study
Author(s) -
Coristine Ron W.,
Hartford Kathleen,
Vingilis Evelyn,
White Dawn
Publication year - 2007
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2006.00759.x
Subject(s) - triage , mental health , workload , qualitative research , focus group , stressor , nursing , medicine , intervention (counseling) , psychology , psychiatry , sociology , computer science , social science , anthropology , operating system
Rationale, aims and objectives The London Health Sciences Centre found that its emergency room (ER) mental health services were affected by people presenting with problems that did not require psychiatric intervention. Consequently, a second triage using a crisis worker (CW) was introduced in the ER to identify those persons with mental illness (PMI) who presented for social stressors related to housing, finances and legal issues. A qualitative, process evaluation study was conducted to capture experiences and perceptions of the new triage and CW. Method Qualitative input was obtained from a broad range of stakeholders in three waves of data‐gathering over a 25‐month period. This method allowed corroboration of findings from informants with varying interests and backgrounds. The data were collected through interviews, focus groups and surveys. The NUD‐ist Qualitative Data Analysis Software Program was used to conduct content analyses. Results Many PMI seeking ER mental health services are presenting with problems related to social stressors and being referred by the second triage to the CW. The introduction of the second triage CW has had a positive effect on ER functioning, the workload of ER staff and the experience of persons presenting at ER. Conclusions A defined triage process coupled with the use of psychiatric nursing staff may be applicable to ERs within general hospital settings to improve ER functioning, focus support for PMI and further integrate ERs within the community mental health model.