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P0266 - Screening for poor mental health functioning in a US inner-city emergency department

Published online by Cambridge University Press:  16 April 2020

B.M. Booth ,
F.C. Blow ,
M.A. Walton ,
S.T. Chermack ,
K. Barry ,
L.S. Massey  and
R. Cunningham
B.M. Booth
Affiliation:
Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
F.C. Blow
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Ann Arbor VA Medical Center, Ann Arbor, MI, USA
M.A. Walton
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Ann Arbor VA Medical Center, Ann Arbor, MI, USA
S.T. Chermack
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Ann Arbor VA Medical Center, Ann Arbor, MI, USA
K. Barry
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Ann Arbor VA Medical Center, Ann Arbor, MI, USA
L.S. Massey
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
R. Cunningham
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

Abstract

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Background:

Many mentally distressed individuals seek emergency department (ED) care in the US, but the extent and correlates of significant mental health problems in such patients is unknown.

Methods:

All patients aged 18-60 presenting to an inner-city midwestern US ED April 2006-March 2007 were approached to participate in brief health screening. Exclusions were serious trauma preventing interview, unable to provide informed consent, pregnancy, acute suicidality, or presenting for psychiatric evaluation. Consenting patients completed a short web-tablet screen, including SF-12 for mental and physical health status, recent substance use and DSM-IV diagnoses of substance use disorders.

Results:

The lowest 25% on the SF-12 Mental Health Component were assigned to “poor mental health functioning” (PMHF). 5641 patients participated (58% female, 57% African-American). In bivariate analysis, the PMHF group was significantly more likely to be unmarried, female, use cocaine and marijuana, and binge drink in the past year, and have DSM-IV substance use disorders. Multiple logistic regression found that being female (OR=1.8), older (OR=1.01), not being married (OR=1.2) and DSM-IV alcohol abuse and dependence (OR=1.7, 2.4), cocaine abuse and dependence (OR=1.9, 2.0), and marijuana dependence (OR=1.7) were all independent predictors of PMHF. In a separate model, use of cocaine (OR=2.7) and marijuana (OR=1.7) but not use of alcohol, were independent predictors of PMHF as well as gender, age, and marital status.

Conclusions:

Therefore PMHF in ED patients is strongly associated with recent substance use. ED clinicians should regularly ascertain both mental health status and substance use and refer for additional services where appropriate.

Type
Poster Session II: Epidemiology
Information
European Psychiatry , Volume 23 , Issue S2: 16th AEP Congress - Abstract book - 16th AEP Congress , April 2008 , pp. S271
Copyright
Copyright © European Psychiatric Association 2008
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