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Adm Policy Ment Health. 2019 Jan;46(1):18-33. doi: 10.1007/s10488-018-0889-3.

Use of Emergency Rooms for Mental Health Reasons in Quebec: Barriers and Facilitators.

Author information

1
Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada. flemar@douglas.mcgill.ca.
2
Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada. flemar@douglas.mcgill.ca.
3
Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.
4
Department of Health Administration, Policy and Evaluation School of Public Health, University of Montreal, Montreal, QC, Canada.
5
School of Social Work, Laval University, Quebec City, QC, Canada.

Abstract

This study explored barriers and facilitators in mental health (MH) patient management in four Quebec (Canada) emergency rooms (ERs) that used different operational models. Forty-nine stakeholders (managers, physicians, ER and addiction liaison team members) completed semi-structured interviews. Barriers and facilitators affecting patient management emanated from health systems, patients, organizations, and from professionals themselves. Effective management of MH patients requires ER access to a rich network of outpatient, community-based MH services; integration of general and psychiatric ERs; on-site addiction liaison teams; round-the-clock ER staffing, including psychiatrists; ER staff training in MH; and adaptation to frequent and challenging ER users.

KEYWORDS:

Barriers; Emergency rooms; Facilitators; Mental health patient management; Qualitative methods

PMID:
30074113
DOI:
10.1007/s10488-018-0889-3

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