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2015 ; 60
(9
): 393-402
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Urgent Psychiatric Services: A Scoping Review
#MMPMID26454727
Sunderji N
; de Bibiana JT
; Stergiopoulos V
Can J Psychiatry
2015[Sep]; 60
(9
): 393-402
PMID26454727
show ga
OBJECTIVE: Urgent psychiatric services can provide timely access to ambulatory
psychiatric assessment and short-term treatment for patients experiencing a
mental health crisis or risk of rapid deterioration requiring hospitalization,
yet little is known about how best to organize mental health service delivery for
this population. Our scoping review was conducted to identify knowledge gaps and
inform program development and quality improvement. METHOD: We searched MEDLINE,
PsycINFO, CINAHL, Embase, and EBM Reviews for English-language articles,
published from January 1993 to June 2014, using relevant key words and subject
headings. Reverse and forward citations were manually searched using reference
lists and Google Scholar. Articles were included if they described programs
providing ambulatory psychiatric assessment (with or without treatment) within 2
weeks of referral. RESULTS: We identified 10 programs providing urgent
psychiatric services. Programs targeted a diagnostically heterogeneous population
with acute risks and intensive needs. Most programs included a structured process
for triage, strategies to improve accessibility and attendance, interprofessional
staffing, short-term treatment, and efforts to improve continuity of care.
Despite substantial methodological limitations, studies reported improvements in
symptom severity, distress, psychosocial functioning, mental health-related
quality of life, subjective well-being, and satisfaction with care, as well as
decreased wait times for post-emergency department (ED) ambulatory care, and
averted ED visits and admissions. CONCLUSIONS: Urgent psychiatric services may be
an important part of the continuum of mental health services. Further work is
needed to clarify the role of urgent psychiatric services, develop standards or
best practices, and evaluate outcomes using rigorous methodologies.
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