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Mental Health, SUD Issues Prevalent Among Nonpsychiatric ER Patients
About 45% of patients who visit emergency departments for physical injuries and ailments also have mental health and substance use issues, according to researchers at Indiana University. Furthermore, patients who report high levels of suicidal thinking and plans are more likely to frequent emergency departments.
Findings from the study, which were published in the Journal of the American College of Emergency Physicians, are based on the use of a computer adaptive test to screen for mental health and substance use problems in emergency department patients with nonpsychiatric complaints.
To conduct the study, researchers asked randomly selected patients in Indianapolis area emergency departments to complete the Computerized Adaptive Test-Mental Health, which screens for 5 conditions: depression, anxiety, post-traumatic stress disorder (PTSD), suicidality, and substance use disorder (SUD). Questions in the assessment were adjusted based on respondents’ answers.
Of 794 patients to complete the assessment, 24% were at moderate to severe risk for suicidality, 20.4% for SUD, 16.5% for anxiety, 12.3% for PTSD, and 8.3% for depression. Additionally, among those with at least 2 emergency department visits in the past year, 62% had increased odds for posing a moderate to severe risk for suicidality compared to those with no prior visits.
Patients who die by suicide often visit emergency departments or access the healthcare system for a nonpsychiatric reason shortly before their suicide attempt, according to past research cited in a news release announcing the findings.
The study results are important both for healthcare companies as well as health economists, study principal investigator Brian D’Onofrio, a professor of psychological and brain sciences in the College of Arts and Sciences at IU Bloomington, said in the news release.
“The people who keep coming back to the emergency department are high-risk patients,” D’Onofrio said. “It’s a place where screening could be very helpful to identify people who are at high risk—whether for suicide, depression, anxiety, PTSD or substance use problems—and to get them the care they need.”
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