Examining Mental Health Act usage in an urban emergency department
Objective: In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney. Methods: All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record...
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Veröffentlicht in: | Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists 2015-10, Vol.23 (5), p.517-519 |
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container_title | Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists |
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creator | Derrick, Kate Chia, Justin O’Donovan, Sarah Emerton, Alexandra Hamlyn, Marika Wand, Timothy |
description | Objective:
In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney.
Methods:
All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record of each individual was reviewed by a member of the research team using an audit tool developed for the study. Any uncertainty over individual cases was addressed through research team consensus.
Results:
A total of 172 MHA certificates were collected; 67 were written by police, 45 by ambulance, 54 by medical officers and three by accredited persons. Three magistrate orders for assessment were also received. Seventy percent of police and 60% of ambulance MHA certificates did not result in admission. Over a third were revoked by ED physicians. Forty-five people (32.4%) who presented voluntarily were subsequently detained.
Conclusions:
Police and ambulance MHA certification was a poor predictor of admission. Least restrictive measures were predominantly the outcome. Delegating ED physicians with authorised medical officer status assisted in facilitating this process. Formalised education and training on the principles and practicalities of MHA legislation should be ongoing for all professionals involved. |
doi_str_mv | 10.1177/1039856215590255 |
format | Article |
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In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney.
Methods:
All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record of each individual was reviewed by a member of the research team using an audit tool developed for the study. Any uncertainty over individual cases was addressed through research team consensus.
Results:
A total of 172 MHA certificates were collected; 67 were written by police, 45 by ambulance, 54 by medical officers and three by accredited persons. Three magistrate orders for assessment were also received. Seventy percent of police and 60% of ambulance MHA certificates did not result in admission. Over a third were revoked by ED physicians. Forty-five people (32.4%) who presented voluntarily were subsequently detained.
Conclusions:
Police and ambulance MHA certification was a poor predictor of admission. Least restrictive measures were predominantly the outcome. Delegating ED physicians with authorised medical officer status assisted in facilitating this process. Formalised education and training on the principles and practicalities of MHA legislation should be ongoing for all professionals involved.</description><identifier>ISSN: 1039-8562</identifier><identifier>EISSN: 1440-1665</identifier><identifier>DOI: 10.1177/1039856215590255</identifier><identifier>PMID: 26104779</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject><![CDATA[Emergency Service, Hospital - statistics & numerical data ; Hospitals, Teaching - statistics & numerical data ; Hospitals, Urban - statistics & numerical data ; Humans ; Mental Health - legislation & jurisprudence ; Mental Health - statistics & numerical data ; New South Wales ; Patient Admission - statistics & numerical data]]></subject><ispartof>Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists, 2015-10, Vol.23 (5), p.517-519</ispartof><rights>The Royal Australian and New Zealand College of Psychiatrists 2015</rights><rights>The Royal Australian and New Zealand College of Psychiatrists 2015.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-2f49033a0e6e0aeb901bb0873c649bb4f3035a240080b37e02b0e61d15622ba13</citedby><cites>FETCH-LOGICAL-c337t-2f49033a0e6e0aeb901bb0873c649bb4f3035a240080b37e02b0e61d15622ba13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1039856215590255$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1039856215590255$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26104779$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Derrick, Kate</creatorcontrib><creatorcontrib>Chia, Justin</creatorcontrib><creatorcontrib>O’Donovan, Sarah</creatorcontrib><creatorcontrib>Emerton, Alexandra</creatorcontrib><creatorcontrib>Hamlyn, Marika</creatorcontrib><creatorcontrib>Wand, Timothy</creatorcontrib><title>Examining Mental Health Act usage in an urban emergency department</title><title>Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists</title><addtitle>Australas Psychiatry</addtitle><description>Objective:
In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney.
Methods:
All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record of each individual was reviewed by a member of the research team using an audit tool developed for the study. Any uncertainty over individual cases was addressed through research team consensus.
Results:
A total of 172 MHA certificates were collected; 67 were written by police, 45 by ambulance, 54 by medical officers and three by accredited persons. Three magistrate orders for assessment were also received. Seventy percent of police and 60% of ambulance MHA certificates did not result in admission. Over a third were revoked by ED physicians. Forty-five people (32.4%) who presented voluntarily were subsequently detained.
Conclusions:
Police and ambulance MHA certification was a poor predictor of admission. Least restrictive measures were predominantly the outcome. Delegating ED physicians with authorised medical officer status assisted in facilitating this process. Formalised education and training on the principles and practicalities of MHA legislation should be ongoing for all professionals involved.</description><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Hospitals, Teaching - statistics & numerical data</subject><subject>Hospitals, Urban - statistics & numerical data</subject><subject>Humans</subject><subject>Mental Health - legislation & jurisprudence</subject><subject>Mental Health - statistics & numerical data</subject><subject>New South Wales</subject><subject>Patient Admission - statistics & numerical data</subject><issn>1039-8562</issn><issn>1440-1665</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kL1PwzAQxS0EoqWwMyGPLIFz_JF6LFWhSEUsMEd2eimpEqfYiUT_exy1MCCx3J10v_d09wi5ZnDHWJbdM-B6KlXKpNSQSnlCxkwISJhS8jTOcZ0M-xG5CGELAFOZqnMyShUDkWV6TB4WX6apXOU29AVdZ2q6RFN3H3RWdLQPZoO0ctQ42nsbKzboN-iKPV3jzviuiZpLclaaOuDVsU_I--Pibb5MVq9Pz_PZKik4z7okLYUGzg2gQjBoNTBrYZrxQgltrSg5cGlSEY8EyzOE1EaUrVm8P7WG8Qm5PfjufPvZY-jypgoF1rVx2PYhZxlTWoDSAwoHtPBtCB7LfOerxvh9ziAfksv_JhclN0f33ja4_hX8RBWB5AAMoeTbtvcufvu_4TfN_XOL</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Derrick, Kate</creator><creator>Chia, Justin</creator><creator>O’Donovan, Sarah</creator><creator>Emerton, Alexandra</creator><creator>Hamlyn, Marika</creator><creator>Wand, Timothy</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>Examining Mental Health Act usage in an urban emergency department</title><author>Derrick, Kate ; Chia, Justin ; O’Donovan, Sarah ; Emerton, Alexandra ; Hamlyn, Marika ; Wand, Timothy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-2f49033a0e6e0aeb901bb0873c649bb4f3035a240080b37e02b0e61d15622ba13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Emergency Service, Hospital - statistics & numerical data</topic><topic>Hospitals, Teaching - statistics & numerical data</topic><topic>Hospitals, Urban - statistics & numerical data</topic><topic>Humans</topic><topic>Mental Health - legislation & jurisprudence</topic><topic>Mental Health - statistics & numerical data</topic><topic>New South Wales</topic><topic>Patient Admission - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Derrick, Kate</creatorcontrib><creatorcontrib>Chia, Justin</creatorcontrib><creatorcontrib>O’Donovan, Sarah</creatorcontrib><creatorcontrib>Emerton, Alexandra</creatorcontrib><creatorcontrib>Hamlyn, Marika</creatorcontrib><creatorcontrib>Wand, Timothy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Derrick, Kate</au><au>Chia, Justin</au><au>O’Donovan, Sarah</au><au>Emerton, Alexandra</au><au>Hamlyn, Marika</au><au>Wand, Timothy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Examining Mental Health Act usage in an urban emergency department</atitle><jtitle>Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists</jtitle><addtitle>Australas Psychiatry</addtitle><date>2015-10</date><risdate>2015</risdate><volume>23</volume><issue>5</issue><spage>517</spage><epage>519</epage><pages>517-519</pages><issn>1039-8562</issn><eissn>1440-1665</eissn><abstract>Objective:
In this study we aimed to examine the characteristics of Mental Health Act (MHA) usage in the Emergency Department (ED) of an urban teaching hospital in Sydney.
Methods:
All MHA certificates written on individuals in the ED over a 12-week period in 2013 were collected. The medical record of each individual was reviewed by a member of the research team using an audit tool developed for the study. Any uncertainty over individual cases was addressed through research team consensus.
Results:
A total of 172 MHA certificates were collected; 67 were written by police, 45 by ambulance, 54 by medical officers and three by accredited persons. Three magistrate orders for assessment were also received. Seventy percent of police and 60% of ambulance MHA certificates did not result in admission. Over a third were revoked by ED physicians. Forty-five people (32.4%) who presented voluntarily were subsequently detained.
Conclusions:
Police and ambulance MHA certification was a poor predictor of admission. Least restrictive measures were predominantly the outcome. Delegating ED physicians with authorised medical officer status assisted in facilitating this process. Formalised education and training on the principles and practicalities of MHA legislation should be ongoing for all professionals involved.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>26104779</pmid><doi>10.1177/1039856215590255</doi><tpages>3</tpages></addata></record> |
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language | eng |
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source | SAGE Complete A-Z List; MEDLINE |
subjects | Emergency Service, Hospital - statistics & numerical data Hospitals, Teaching - statistics & numerical data Hospitals, Urban - statistics & numerical data Humans Mental Health - legislation & jurisprudence Mental Health - statistics & numerical data New South Wales Patient Admission - statistics & numerical data |
title | Examining Mental Health Act usage in an urban emergency department |
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