Magazine article Clinical Psychiatry News

Some Suicidal Patients Leave Emergency Department Too Soon

Magazine article Clinical Psychiatry News

Some Suicidal Patients Leave Emergency Department Too Soon

Article excerpt

TUCSON, ARIZ. -- Preliminary results from a study of psychiatric patients who left an emergency department without treatment suggest many were anxious, agitated, and at risk for harm to themselves and others.

Among patients in the initial review, 10% had suicidal ideation as their chief complaint, Dr. Pamela Siller and Dr. Hindi T. Mermelstein reported in a poster at the annual meeting of the Academy of Psychosomatic Medicine.

Anxiety-related problems, including agitation and panic attacks, were the most common complaints, occurring in 37.5% of patients who left the emergency department before evaluation. "This is counterintuitive. Depression [was] the No. 1 chief complaint of the [psychiatric] patients who were admitted to the hospital," said Dr. Siller of North Shore University Hospital in Manhasset, N.Y., where the study was conducted.

Whereas 25% of the eloped psychiatric patients cited substance abuse, an equal proportion had asked to see a psychiatrist. Their charts did not indicate why.

Lack of insurance and long waiting room times--two common reasons for patients to leave prior to evaluation--did not appear to be factors in the patients' decision to leave before treatment, according to the investigators. All but 5% of the population were insured, and the 12% of patients who arrived by ambulance were sent directly to a designated room with psychiatric observation.

All told, 43% of the psychiatric patients who eloped were in the interior of the emergency department. …

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