Profile and Assessment Outcome of Patients in the Emergency Department Managed by Consultation-liaison Psychiatry: A Cross-sectional Study

Abstract Background: Outcomes following consultation-liaison psychiatry (CLP) assessment provide key direction for mental health care regarding crisis intervention. Aim: We intended to find the clinical characteristics of all consecutive psychiatric patients referred to CLP in a month ( n = 100), specifically reasons for referral, diagnoses, stressors, the outcomes of the assessment, and subsequent care pathways. Settings and Design: Emergency department in a General Hospital. A cross-sectional study. Methods and Material: Data was extracted from electronic patient records in a predesigned proforma. International Classification of Disease-10 and index of multiple deprivations were used. Statistical Analysis: Percentages, mean and standard deviation. Results: The sample (56 male and 44 female patients) mostly belonged to the deprived areas of the city. The majority (90%) of them presented with thoughts or behaviors related to self-harm or suicide. Most (73.0%) of them had psychiatric diagnoses; depression (36%) was the most common, followed by personality disorders (22%) and alcohol or substance use disorders (17%), and many of them had comorbidities. Almost half of the patients (48%) had self-harm history. A considerable proportion (40%) was under the influence of substances when they attended the emergency department. Common psychosocial stressors were relational problems (38%) with partner or family followed by pandemic-related concerns (19%). More than a third (37%) of the sample was seen in the previous 12 months, and the re-attendance rate in the 3 months following the study was 21%. While acute psychiatric care was provided to around 30% (inpatient admission: 13% and home treatment: 17%), 24% were discharged to general practitioners and 18% to community mental health teams. Conclusions: Most patients managed by CLP had multiple complex clinical needs along with suicidality. This suggested that a robust suicide risk management strategy and supportive resources are essential components of CLP care.