Skip to main content Accessibility help
×
Home

Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014

  • James Dove (a1), Amit Mistry (a2), Nomi Werbeloff (a1) (a3), David Osborn (a1) (a4) and Nora Turjanski (a1)...

Abstract

Aims and method

To identify temporal and demographic trends in referrals made to psychiatric liaison services. Routine clinical data from 16 105 individual referrals from three central London accident and emergency (A&E) departments to psychiatric liaison services from 2012 to 2014 were obtained and analysed using the Clinical Record Interactive Search (CRIS).

Results

Referrals from A&E to psychiatric liaison services increased 16% over the 3-year study period. There were fewer referrals to psychiatric liaison services in winter months compared with other seasons. There were fewer referrals to psychiatric liaison services over the weekend compared with weekdays (average 15.4 daily weekday referrals v. 13.2 weekend, z = 5.1, P < 0.001), and weekend referrals were slightly less likely to result in admission to psychiatric hospital (11.3% v. 12.8%, respectively, χ2 = 6.33, P = 0.01).

Clinical implications

Psychiatric staffing in A&E and inpatient psychiatric wards requires planning to meet temporal and regional variations in the pattern of demand.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence to James Dove (james.dove@nhs.net)

References

Hide All
1 Aitken, P, Robens, S, Emmens, T (eds). Developing Models for Liaison Psychiatry Services – Guidance. Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions South West. Devon Partnership NHS Trust, 2014 (http://mentalhealthpartnerships.com/resource/developing-models-for-liaison-psychiatry-services).
2 Joint Commissioning Panel for Mental Health. Guidance for Commissioners of Liaison Mental Health Services to Acute Hospitals. Volume Two: Practical Mental Health Commissioning. Royal College of Psychiatrists’ Joint Commissioning Panel for Mental Health, 2012 (http://www.jcpmh.info/good-services/liaison-mental-health-services/, accessed 14th December 2016).
3 Fisher, E, Dorning, H. Winter Pressures: What's Going on Behind the Scenes? Nuffield Trust and Health Foundation, 2016 (http://www.qualitywatch.org.uk/node/760, accessed 14th December 2016).
5 Flory, D. Winter Pressures (letter). Department of Health, 2011 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215813/dh_123683.pdf, accessed 14th December 2016).
6 Freemantle, N, Daniel, R, McNulty, D, David, R, Bennett, S, Keogh, BE, et al. Increased mortality associated with weekend hospital admission: a case for expanded seven day services? BMJ 2015; 351: h4596.
7 NHS England. NHS Services, Seven Days a Week Forum: Summary of Initial Findings. 2013. (http://www.england.nhs.uk/wp-content/uploads/2013/12/brd-dec-13.pdf, accessed 14th December 2016).
8 The Rt Hon Jeremy Hunt MP. Oral statement to Parliament NHS 7 day services and the junior doctors’ strike. Department of Health, 2016 (https://www.gov.uk/government/speeches/nhs-7-day-services-and-the-junior-doctors-strike, accessed 14th December 2016).
9 Patel, P, Chesney, E, Cullen, AE, Tulloch, AD, Broadbent, M, Stewart, R, et al. Clinical outcomes and mortality associated with weekend admission to psychiatric hospital. Br J Psychiatry 2016; 209(1): 2934.
10 Singh, GP, Chavan, BS, Priti, A, Ajeet, S. Seasonal pattern of psychiatry service utilization in a tertiary care hospital. Indian J Psychiatry 2007; 49(2): 9195.
11 Licanin, I, Fisekovic, S, Babićo, S. Admission rate of patients with most common psychiatric disorders in relation to seasons and climatic factors during 2010/2011. Mater Sociomed 2012; 24(2): 9499.
12 Fernandes, AC, Cloete, D, Broadbent, MT, Hayes, RD, Chang, CK, Jackson, RG, et al. Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records. BMC Med Inform Decis Mak 2013; 13: 71.
13 Werbeloff, N, Markou, M, Hayes, JF, Pitman, AL, Osborn, DP. Individual and area-level risk factors for suicidal ideation and attempt in people with severe depression. J Affect Disord 2016; 205: 387392.
14 Thinn, DSS, Kuswanto, CN, Sum, MY, Chai, SB, Sok, HKD, Xu, C, et al. The 23-hour observation unit admissions within the emergency service at a national tertiary psychiatric hospital: clarifying clinical profiles, outcomes, and predictors of subsequent hospitalization. Prim Care Companion CNS Disord 2015; 17(4): doi:10.4088/PCC.15m01789.
15 Goldberg, JF, Ernst, CL, Bird, S. Predicting hospitalization versus discharge of suicidal patients presenting to a psychiatric emergency service. Psychiatr Serv 2007; 58(4): 561565.
16 Lyons, JS, Stutesman, J, Neme, J, Vessey, JT, O'Mahoney, MT, Camper, HJ. Predicting psychiatric emergency admissions and hospital outcome. Med Care 1997; 35(8): 792800.
17 Way, BB, Banks, S. Clinical factors related to admission and release decisions in psychiatric emergency services. Psychiatr Serv 2001; 52(2): 214218.
18 Kunen, S, Prejean, C, Gladney, B, Harper, D, Mandry, CV. Disposition of emergency department patients with psychiatric comorbidity: results from the 2004 National Hospital Ambulatory Medical Care Survey. Emerg Med J 2006; 23(4): 274275.
19 Rabinowitz, J, Massad, A, Fennig, S. Factors influencing disposition decisions for patients seen in a psychiatric emergency service. Psychiatr Serv 1995; 46(7): 712718.
20 Unick, GJ, Kessell, E, Woodard, EK, Leary, M, Dilley, JW, Shumway, M. Factors affecting psychiatric inpatient hospitalization from a psychiatric emergency service. Gen Hosp Psychiatry 2011; 33(6): 618625.

Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014

  • James Dove (a1), Amit Mistry (a2), Nomi Werbeloff (a1) (a3), David Osborn (a1) (a4) and Nora Turjanski (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Weekday and seasonal patterns in psychiatric referrals in three major London A&E departments, 2012–2014

  • James Dove (a1), Amit Mistry (a2), Nomi Werbeloff (a1) (a3), David Osborn (a1) (a4) and Nora Turjanski (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *