Key concepts

Mental health-related services in emergency departments

Key concept Description

Emergency department (ED) presentation

Emergency department (ED) presentation refers to the period of treatment or care between when a patient presents at an emergency department and when that person is recorded as having physically departed the emergency department. It includes presentations for patients who do not wait for treatment once registered or triaged in the emergency department, those who are dead on arrival, and those who are subsequently admitted to hospital or to beds or units in the emergency department. An individual may have multiple presentations in a year. For further information, see the Non-admitted emergency department care NMDS 2015–16.

Episdode end status The episode end status indicates the status of the patient at the end of the non-admitted patient emergency department service episode. Further details on episode end status codes are available Non-admitted patient emergency department service episode end status .

Mental health‑related emergency department (ED)presentation

Mental health‑related emergency department (ED) presentation refers to an emergency department presentation that has a principal diagnosis that falls within the Mental and behavioural disorders chapter (Chapter 5) of ICD‑10‑AM (codes F00–F99) or the equivalent ICD‑9‑CM or SNOMED codes. It should be noted that this definition does not encompass all mental health‑related presentations to emergency departments, as detailed above. Additional information about this and applicable caveats can be found in the data source section.

Principal diagnosis

The principal diagnosis is the diagnosis established at the conclusion of the patient’s attendance in an emergency department to be mainly responsible for occasioning the attendance.

Triage

The triage category indicates the urgency of the patient’s need for medical and nursing care. It is usually assigned by an experienced registered nurse or medical practitioner at, or shortly after, the time of presentation to the emergency department. The triage category assigned is in response to the question: ‘This patient should wait for medical assessment and treatment no longer than...?’

The Australasian Triage Scale has 5 categories that incorporate the time by which the patient should receive care:

Resuscitation: immediate (within seconds)

Emergency: within 10 minutes

Urgent: within 30 minutes

Semi-urgent: within 60 minutes

Non-urgent: within 120 minutes.

Alternative text for mental health services provided in emergency department figures

Figure ED.1

Vertical bar chart showing the rate (per cent) of mental health-related emergency department presentations in public hospitals by state or territory in 2016–17. SA had the highest per cent of mental health-related ED presentations accounting for 4.8% of all ED presentations, followed by 4.2% in the NT, 3.9% in Tas, 3.9% in Qld, 3.8% in WA, 3.4% in NSW, 3.3% in the ACT and 3.1% in Vic. The national result was 3.6%. Refer to Table ED.4. Back to Figure ED.1

Figure ED.2

Horizontal bar chart showing the rate (per 10,000 population specific) of mental health-related emergency department presentations in public hospitals by patient demographics in 2016–17. Patients 15–24 years had the highest rate (per 10,000 age specific population) of mental health-related ED presentations 192.6, followed by 35–44 (164.8), 25–34 (160.6), 45–54 (125.9), 65 and older (81.8), 55–64 (76.9) and less than 15 (25.0). A higher rate of males (119.0) compared with females (108.2). A higher rate of Indigenous Australians (443.0) compared with non-Indigenous Australians (105.0). The rate increased with increasing remoteness area; 101.2 per 10,000 in major cities, 126.7 inner regional, 128.3 outer regional and 185.3 remote and very remote areas. Mental health related presentations decreased with increasing socioeconomic quintile with 147.3 presentations per 10,000 for most disadvantaged quintile, to 75.7 for the least disadvantaged quintile. Refer to Table ED.6. Back to figure ED.2

Figure ED.3

Horizontal bar chart showing mental health-related emergency department presentations in public hospitals by principal diagnosis in 2016–17. Majority of mental health-related ED presentations were mental and behavioural disorders due to psychoactive substance, and neurotic, stress-related and somatoform disorders (26.9% and 26.7% respectively). Mood (affective) disorders made up 11.6% presentations, schizophrenia, schizotypal and delusional disorders 11.4%, mental disorder not otherwise specified 9.6%, organic, including symptomatic, mental disorders 7.5%, disorders of adult personality and behaviour 2.7%, behavioural and emotional disorders with onset usually occurring in childhood 2.6%, behavioural syndromes associated with physiological disturbances and physical factors and adolescence 0.9%, and disorders of psychological development 0.1%. Refer to Table ED.9. Back to figure ED.3

Figure ED.4

Pie chart showing mental health-related ED presentations in public hospitals by triage category. In 2016–17, 48.7% of mental health-related ED presentations were urgent, 30.5% semi-urgent, 13.5% emergency, 6.4% non-urgent, and 0.9% resuscitation. Refer to Table ED.3. Back to figure ED.4

Figure ED.5

Scatterplot chart presenting mental health-related ED presentation wait time (minutes) for 50% and 90% of patients by State and Territory, 2016–17. Fifty per cent of patients waited up to 30 minutes in Western Australia and Tasmania, 28 minutes in the Australian Capital Territory, 26 minutes South Australia and Northern Territory, 21 minutes Queensland, 18 minutes Victoria and 14 minutes New South Wales. Across Australia 50% of patients waited up to 19 minutes. A similar pattern emerged for 90% of patients who waited up to 138 minutes in Western Australia, 134 minutes South Australia, 129 minutes Northern Territory, 128 minutes Tasmania, 127 minutes Australian Capital Territory, 107 minutes Queensland, 90 minutes Victoria and 79 minutes New South Wales. Across Australia 90% of patients waited up to 103 minutes. Refer to Table ED.8. Back to figure ED.5.

Figure ED.6

Scatterplot chart presenting mental health-related ED presentations length of stay (minutes) for 50% and 90% of patients by State and Territory, 2016–17. Fifty per cent of patients stayed in the ED for up to 260 minutes in South Australia, 246 minutes Tasmania, 232 minutes Western Australia, 271 minutes Australian Capital Territory, 213 minutes Victoria, 207 minutes Northern Territory, 195 minutes Queensland, and 188 minutes New South Wales. Across Australia 50% of patients stayed up to 207 minutes in the ED. Ninety per cent of patients who presented to ED with a mental and behavioural diagnosis stayed up to 984 minutes in South Australia, 895 minutes Western Australia, 854 minutes Tasmania, 738 minutes Victoria, 661 minutes Northern Territory, 640 minutes Australian Capital Territory, 613 minutes New South Wales, and 542 minutes Queensland. Across Australia 90% of patients stayed up to 688 minutes. Refer to Table ED.12. Back to figure ED.6