Innovative Use of Brief Interventions in Emergency Department Attendees: The Incidence of Mental Health Disorders and Alcohol Consumption
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Purpose: Systematic assessment of all Emergency Department (ED) presentations may identify low level mental illness and/or risky alcohol consumption. Preventative measures, if provided early, may prevent further deterioration and promote wellness. Background: The 2007 National Health Survey revealed one in five adults aged 16 - 85 experienced a mental disorder in the previous year, however only 35% sought assistance. The potential demand for mental health care is high but is not being met by either the specialist or the general health system. Unplanned contact with the health care system via the ED offers clinician’s an opportunity to identify patients with psychiatric co-morbidity and refer them to appropriate therapy. Study aims: To gather data regarding the incidence of low level mental health disorders and/or risky alcohol use; and determine the sample size required to trial a brief intervention and follow-up with ED attendees. Methods: A survey designed to gather descriptive, observational epidemiological data. All eligible patients who presented to the ED during specified data collection periods were invited to participate Results: Participation rate was 73.3% (n = 708) 966 potential participants 254 refusals (26.3%) 4 exclusions (0.04%) Alcohol Almost 70% (n=493) reported drinking alcohol. 10.9% at risky/harmful levels (AUDIT) 31.1% at hazardous/dependent levels (PAT) Mental Health A significant proportion experienced low level mental health symptoms DASS21 (mild/moderate): depression (18.1%), anxiety (22.6%) and stress (16.7%). K10 (moderate): 19.5% Co-morbidity Within the target mental health group (mild and moderate symptoms) Between 44-48% reported drinking at hazardous levels (AUDIT) Between 29-39% reported drinking at harmful levels (AUDIT) Approximately 30% drank at hazardous/dependent levels (PAT) Conclusion: Co-morbidity was apparent with positively significant correlations between mental health and measures of alcohol consumption. This group may be amenable to brief interventions.