Urgent outpatient care following mental health ED visits: a population-based study

Objective — Follow-up after psychiatric emergency department (ED) contact is key to optimizing outcomes for vulnerable patients. We aimed to quantify the likelihood of receiving outpatient mental healthcare after psychiatric ED visits in a population-level sample.

Methods — Among individuals who presented for a psychiatric ED visit in Ontario, Canada (2010–2012) and were not admitted to hospital (N=143,662), the authors estimated the likelihood of outpatient physician mental healthcare within 14 days post-ED visit and compared this across presenting diagnoses.

Results — About 40.2% (N=57,797) had a follow-up mental health visit within 14 days post-ED. Follow-up was lower among individuals presenting with substance use disorders (25.2%) than among those presenting with disorders not primarily related to substance use (44.5%) (χ²=3,784.7, df=1, p<0.001). Follow-up differed among those presenting with schizophrenia (46.4%), bipolar disorder (56.1%), and major depressive disorder (51.1%) (χ²=61.7, df=2, p<0.001).

Conclusions — Post-ED outpatient mental health follow-up is low. Systemwide coordination is needed to connect these high-acuity patients with care, especially those with presentations related to substance use.