Patients released from emergency departments without assessment (USA)
A national retrospective study of adult Medicaid recipients in the USA found that patients who presented in emergency departments (ED) due to self-harm were more likely to be discharged back into the community, than to an inpatient facility. Furthermore, these patients were often discharged without receiving a psychiatric evaluation and did not receive referrals to follow-up care.
Mark Olfson, MD, professor of clinical psychiatry at Columbia University and research psychiatrist at the New York State Psychiatric Institute, New York City, has suggested that these results represent an opportunity for EDs to improve their service.
Suggestions for EDs include:
- Re-evaluation of staffing patterns;
- A shift of focus from merely stabilizing patients to also providing psychological evaluations to help identify continuing risk factors for suicide; and
- Development of referral networks.
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