Disability and Functioning of Patients Who Use Psychiatric Hospital Emergency Services

Objective: First, to compare the level of disability and functioning of patients who access psychiatric emergency services by diagnosis and service use frequency. Second, to compare patients who access psychiatric emergency services to the general population in terms of demographics and the level of disability and functioning.

Methods: Data from 420 patients were obtained by time-based sampling from August 2011 to February 2012 in the emergency department of a psychiatric hospital that provides services to adolescents and adults. The 2011 and 2012 Centre for Addiction and Mental Health Monitor surveys were used as a representative adult general population sample. Disability and functioning were measured using the World Health Organization Disability Assessment Schedule (WHODAS).

Results: Variation in WHODAS scores among psychiatric emergency patients was observed within but not between diagnostic categories and within frequency of use of these services categories. Psychiatric emergency patients had a mean WHODAS score of 38.0, significantly higher (P < .001) than the mean score of 5.0 for the general population; however, there was overlap in the distribution of WHODAS scores. Compared to the general population, psychiatric emergency patients were more likely to be men, younger in age, never married, and unemployed or a student.

Conclusions: Psychiatric emergency patients are demographically different when compared to the general population. Furthermore, since disability and functioning are highly variable within but not between psychiatric diagnostic categories, data on disability and functioning should be collected for psychiatric emergency patients, in addition to diagnosis data, to more accurately align patients with the appropriate intensity of services.

J Clin Psychiatry 2016;77(10):e1278–e1286