Mental health assessments and models of care in the emergency department: A scoping review.

Abstract

Background/aim: Emergency departments are seeing an increase in mental health presentations across the globe, however there is no standard mental health assessment models of care currently being used in emergency departments. Population/setting: Mental Health and emergency department. Methods: This scoping review aims to search the literature and report the mental health models of care used globally. This scoping review conducted a search of 4 medical databases, Medline Complete, CINAHL, Embase and PsychINFO, the research team screened title and abstracts and reviewed the full text. Risk of bias and quality assessment was conducted by 2 independent researchers. Results/findings: A total of 2461 articles were identified for title and abstract screening, of these, 84 were reviewed in full text and subsequently 79 articles were excluded, resulting in 5 articles to be included in this scoping review. Two articles assessed the Psychiatric Assessment and Planning Unit (PAPU) model and reported on reduced length of stay, a third article reported a similar model and improved length of stay. Two articles reported models on sub-sample cohorts of mental health; individuals experiencing suicide ideation and individuals experience alcohol and substance use issues. Conclusion: he results of this scoping review highlight the lack of literature concerning models of care and mental health assessment in emergency departments. Of the few articles reviewed, a successful model of care requires a dedicated physical space in the emergency department including mental health short stay beds and dedicated mental health staff. Translational impact/implications for future practice: Considering the increase in mental health presentations to ED’s, future directions include; hospitals providing trained mental health ED staff and or providing mental health beds in the ED, as a way to possibly alleviate the pressures on ED staff and provide better supports for patients.