Strategies for preventing excess mortality after discharge from psychiatric emergency room

AbstractPatients with severe mental illness have increased risk for severe physical diseases. In addition, there is evidence that this patient group is less likely to receive standard levels of care for most physical diseases, which may contribute to their shortened life expectancy. Further, illness behaviour among individuals with schizophrenia is different as they are less likely to seek medical attention, which emphasise the need for increased awareness and early intervention when visiting an emergency psychiatric facility. Adults with severe mental illness have increased rates of substance abuse, which adversely affect their illness and outcome. Separate and parallel mental health and substance abuse treatment systems do not offer interventions that are integrated or personalised for the presence of substance abuse concurrent with severe mental illness. Therefore, the authors suggest an establishment of multidisciplinary teams capable of delivering a full range of psychiatric interventions and integrated treatment for substance use disorder in the community and psychiatric emergency room to those who otherwise would have required admission to an acute hospital bed.  Keywords: Psychiatric emergency room; Crisis resolution; mortality; severe mental illness