Frequent users of the ED contribute to the problem of overcrowding and are more likely to have psychiatric problems and a higher than average 90 day re-admittance rate. In addition, ED visits due to mental health problems have increased in recent years, thus driving up 90 day re-admission rates.

Objectives – To determine the reasons for readmissions of psychiatric patients who had previously presented to the Emergency Department.

Methods – This is a retrospective chart review of a random sample of 350 psychiatric patients who presented to the ED and had a return visit within 90 days. The study was IRB approved.

There was a significant difference (p = .01) between the reasons for psychiatric patients to be re-admitted to the hospital between their first, second, and third ED visit. The most common reason for admittance on the first visit was depression, schizophrenia, schizoaffective disorder, bipolar disorder, and psychosis. The most common reasons for the second and third visit however, were psychiatric (61.9%), musculoskeletal (9.2%), cardiovascular (5.7%), neurological (4.3%), and dermatological (3.2%).

Psychiatric patients are not returning to the ED repeatedly for the same complaints or for only psychiatric complaints. A total of 30% of patients who presented for a second and third time within 90 days who were admitted for medical illness versus their initial psychiatric presentation.