Excessive use of emergency departments (EDs) for the treatment of mental health complaints (MHCs) suggests alternate interventions are required.

To understand attributes of patients who are high frequent users (HFUs) of EDs for the treatment for MHCs.

Suggest realistic changes that would make the health care system more effectively respond to HFUs needs.

Administrative data were used to analyze the use of all three emergency departments in Saskatoon Health Region by patients presenting with primary MHCs in 2012. A chart review of HFUs for the years 2011 to 2013 was also undertaken.

In 2012 approximately 1.2% (3,824) of the Region’s population made the 6,235 visits for a primary MHC. ED visits exhibit a Pareto distribution with most patients (72.8%) making a single visit however < 0.1 % (34) made 10+ visits. HFUs (10+ visits) used EDs in multiple years, over 3 years making an average of 59 ED visits (R=19 to 194). They were generally, young, male, unemployed, transient or homeless with many unmet social and economic needs. They could be categorized into: 1) suffering from severe alcohol abuse/withdrawal or illicit drug use; 2) chronic mood and anxiety disorders; 3) significant personal and social stressors; and 4) a complex combination of psychiatric disease(s) and cognitive impairment.

Action should be taken to identify ‘High Frequency Users’ early in their patient career and develop appropriate interventions taking into account their unique and diverse needs.