Mental health assessments and models of care in the Emergency Department: A narrative review.

Abstract

Emergency departments are seeing an increase in mental health presentations across the globe; however, there are no standard mental health assessment models of care currently being used in emergency departments. This narrative review aims to search the literature and report the mental health models of care used globally. This narrative review conducted a search of 4 medical databases, Medline Complete, CINAHL, Embase and PsychINFO; the research team screened titles and abstracts and reviewed the full text. Risk of bias and quality assessment was conducted by 2 independent researchers. 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 narrative 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 experiencing alcohol and substance use issues. The results of this narrative 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 and/or assessment requires a dedicated physical space in the emergency department (such as a PAPU), including mental health short stay beds and dedicated mental health staff.