Do older patients with mental health presentations stay in the emergency department longer than younger patients? – A retrospective study

Objective This study aimed to analyse the differences in Emergency Departments (EDs) length of stay (LOS) for mental health (MH) presentations between older patients (aged 65 and above) and younger adults, identifying factors contributing to longer stays. Methods A retrospective data analysis of MH patients presenting to MHEDs in three Brisbane hospitals between May 2018 and May 2019 was conducted. We dichotomised LOS around the 75th quartile (20 h), given the skewness of the data. Patients remaining in MHED for longer than 20 h were considered as a prolonged length of stay (PLOS). Results Older patients constituted 4.5% ( n = 423) of the 9452 MH presentations. They were significantly more likely to experience PLOS ( p < .0001). Awaiting admission had an 11-fold increased risk of PLOS (Adjusted OR 9.69–12.48, 95% CI). Additionally, alcohol and drug-related cases were prone to PLOS ( p < .0001), though these factors did not explain the extended stays in the elderly. Conclusion Older MH patients had a significantly longer LOS in MHED compared to younger adults. Neither waiting for admission nor substance-related issues fully accounted for this discrepancy. Further research is needed to explore other potential contributing factors to PLOS, for example, medical comorbidities, psychosocial issues, and systemic-related delays in elderly MH care.