Rapid-access ambulatory psychiatry care, administered through an urgent care psychiatry clinic taking walk-ins only, may lower future ED use rates.1 “We were trying to demonstrate the value of providing outpatient psychiatric care to patients in a rapid access model,” reports David Kroll, MD, the study’s lead author and associate vice chair in the department of psychiatry at Brigham and Women’s Hospital in Boston.
Kroll and colleagues found that for 88 patients who had not received ambulatory psychiatric care, ED use decreased from 0.68 visits per patient to 0.36 in the six months after the encounter. “We are increasingly understanding that the benefits of providing psychiatric care are not limited to the relief of psychiatric symptoms alone,” Kroll notes.
Mental and physical health intersect, and psychiatric care can improve the outcomes of many other general health conditions. The reverse also is true: Psychiatric disorders often lead to worse outcomes from physical health conditions. “This is why we hypothesized that providing rapid access to psychiatric care might be associated with a decreased frequency of physical health emergencies,” Kroll says.
There was a stronger link to reduction in physical health emergencies than there was for psychiatric emergencies. This does not necessarily mean providing psychiatric care is more effective for physical health emergencies than psychiatric emergencies. “Our data were likely affected by a relatively small number of psychiatric emergencies overall,” Kroll explains.
For ED clinicians, an important consideration is that lack of access to outpatient psychiatric care could contribute to the medical emergencies they see. Most EPs are well aware of the shortage of available mental healthcare providers in both inpatient and outpatient settings.
“But having adequate outpatient psychiatry resources in a hospital or healthcare system affects their work, perhaps more than they already realize,” Kroll says.
- Kroll DS, Wrenn K, Grimaldi JA, et al. Impact of a rapid-access ambulatory psychiatry encounter on subsequent emergency department utilization. Community Ment Health J 2021;57:973-978.