Understanding Psychological Distress and Therapeutic Environment in the Emergency Department

NCT06655467 | Not Yet Recruiting

• 1 other identifier: 24/EM/0245
• Study Type: observational
• Target: 398
• Locations: 1 country
• Sites: 1

Brief Summary

This research aims to establish the number of patients coming to Emergency Departments (EDs) with issues relating to mental health, alcohol or drugs, or in some form of psychological distress, including those for whom this was not the main reason for attending ED. We will collect anonymous information on age, gender, ethnicity, when and how they came to the ED, where and how they are cared for whilst in the ED, and what happens to them afterwards. With this information we hope to build a better picture of these patients so we can go on to design and test ways to improve their care in the future.

Conditions

Mental Health; Substance Use (Drugs, Alcohol); Psychological Distress

Outcome Measures

Primary Outcomes (1)

• Proportion fo ED attendance related to issues of mental health, substance use or psychological distress

  Number of patients meeting eligibility criteria, expressed as a proportion of all ED attendances at each site during the study period.

  7 days

Secondary Outcomes (9)

• Proportion of patients physically in ED who meet inclusion criteria at any one time

  7 days

• Comparison with coding data

  7 days

• Admission rate

  7 days

• Length of stay

  30 days

• Specialist mental health or addictions input in ED

  7 days

Interventions

Routine Care BEHAVIORAL

This study involves no change in clinical care and no study specific interventions for participants.

Also known as: Standard Care

Eligibility Criteria

• Age: 11 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients presenting to the Emergency Department (ED) with issues of mental health, substance use or psychological distress, whether or not this was the primary reason for presentation.

You may qualify if:

• Issues of mental health AND/OR
• Issues of substance use AND/OR
• Psychological distress (this refers to patients without an established mental health or substance use disorder who nonetheless present in a distressed state, where distress is not caused by a readily identifiable and treatable physical condition) AND/OR
• Where the treating ED team feel the patient would benefit from some form of mental health or addictions assessment or intervention, whether carried out by ED staff, specialist services or third sector agencies.

You may not qualify if:

• Patients aged 10 and under.
• Patients with distress caused by a physical condition, relieved by appropriate treatment.
• Delirium, unless caused by a mental health- or substance-related disorder.
• Patients with alcohol intoxication alone, without other evidence of harmful use of alcohol and without evidence of psychological distress.

Sponsors & Collaborators

• NHS Fife: lead
• Royal College of Emergency Medicine: collaborator

Study Sites (1)

Victoria Hospital

Kirkcaldy, Fife, KY2 5AH, United Kingdom

Location

Related Publications (11)

• European Taskforce on Geriatric Emergency Medicine (ETGEM) collaborators. Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study. Eur Geriatr Med. 2024 Apr;15(2):463-470. doi: 10.1007/s41999-023-00926-3. Epub 2024 Feb 10.

  PMID: 38340282 BACKGROUND

• McLatchie R, Reed MJ, Freeman N, Parker RA, Wilson S, Goodacre S, Cowan A, Boyle J, Clarke B, Clarke E; DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. Emerg Med J. 2024 Feb 20;41(3):136-144. doi: 10.1136/emermed-2023-213266.

  PMID: 37945311 BACKGROUND

• Reed MJ, Karuranga S, Kearns D, Alawiye S, Clarke B, Mockel M, Karamercan M, Janssens K, Riesgo LG, Torrecilla FM, Golea A, Fernandez Cejas JA, Lupan-Muresan EM, Zaimi E, Nuernberger A, Rennet O, Skjaerbaek C, Polyzogopoulou E, Imecz J, Groff P, Camilleri R, Cimpoesu D, Jovic M, Miro O, Anderson R, Laribi S; SEED investigators. Management of syncope in the Emergency Department: a European prospective cohort study (SEED). Eur J Emerg Med. 2024 Apr 1;31(2):136-146. doi: 10.1097/MEJ.0000000000001101. Epub 2023 Nov 27.

  PMID: 38015745 BACKGROUND

• Odejimi O, Bagchi D, Tadros G. Typology of psychiatric emergency services in the United Kingdom: a narrative literature review. BMC Psychiatry. 2020 Dec 10;20(1):587. doi: 10.1186/s12888-020-02983-5.

  PMID: 33302905 BACKGROUND

• Scottish Government (2017) Mental Health Strategy: 2017-2027. Crown Copyright. Available at: https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2017/03/mental-health-strategy-2017-2027/documents/00516047-pdf/00516047-pdf/govscot%3Adocument/00516047.pdf

  BACKGROUND

• Barratt H, Rojas-Garcia A, Clarke K, Moore A, Whittington C, Stockton S, Thomas J, Pilling S, Raine R. Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis. PLoS One. 2016 Apr 27;11(4):e0154449. doi: 10.1371/journal.pone.0154449. eCollection 2016.

  PMID: 27120350 BACKGROUND

• Baracaia S, McNulty D, Baldwin S, Mytton J, Evison F, Raine R, Giacco D, Hutchings A, Barratt H. Mental health in hospital emergency departments: cross-sectional analysis of attendances in England 2013/2014. Emerg Med J. 2020 Dec;37(12):744-751. doi: 10.1136/emermed-2019-209105. Epub 2020 Nov 5.

  PMID: 33154100 BACKGROUND

• Royal College of Emergency Medicine (2022) James Lind Alliance Emergency Medicine Priority Setting Partnership Refresh 2022. Available at: https://rcem.ac.uk/research-priorities/

  BACKGROUND

• Digel Vandyk A, Young L, MacPhee C, Gillis K. Exploring the Experiences of Persons Who Frequently Visit the Emergency Department for Mental Health-Related Reasons. Qual Health Res. 2018 Mar;28(4):587-599. doi: 10.1177/1049732317746382. Epub 2017 Dec 12.

  PMID: 29231128 BACKGROUND

• Clarke DE, Dusome D, Hughes L. Emergency department from the mental health client's perspective. Int J Ment Health Nurs. 2007 Apr;16(2):126-31. doi: 10.1111/j.1447-0349.2007.00455.x.

  PMID: 17348963 BACKGROUND

• Royal College of Emergency Medicine (2022) RCEM Acute Insight Series: Mental Health Emergency Care. Available at: https://rcem.ac.uk/wp-content/uploads/2022/09/RCEM-Acute-Insight-Series-Mental-Health-Emergency-Care.pdf

  BACKGROUND

MeSH Terms

Conditions

Psychological Well-Being; Substance-Related Disorders

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior; Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Central Study Contacts

Rajendra Raman, MBBChir

CONTACT

+447803814111; rajendra.raman@nhs.scot

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Investigator

Study Record Dates

• First Submitted: October 21, 2024
• First Posted: October 23, 2024
• Study Start: February 3, 2025
• Primary Completion: March 18, 2025
• Study Completion: March 18, 2025
• Last Updated: December 12, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR

Locations

GB (1)