Contacts related to psychiatry and substance abuse in Norwegian casualty clinics

Abstract

Objective. To provide quantitative measurement and analysis of the frequency with which patients contact emergency primary healthcare services in Norway for psychiatric illness, including substance misuse. Characteristics of the patient group and their contact times were also addressed. Design. Cross-sectional observational study. Setting. Data were collected from one district-based and one city-based casualty clinic in Norway. Subjects. Patients seeking medical care during the whole of 2006. Main outcome measures. Patients’ diagnoses, age, gender, and time of contact. Results. Diagnoses related to psychiatric illness were found in 2.7% of all events at the casualty clinics, but were relatively more frequent at night (5.6%) and for home visits and out-of-office emergency responses combined (8.4%). Prevalence was almost doubled during the July holiday month. Prevalence remained relatively constant between ages 15 and 59. The most frequently diagnosed subgroups were depression/suicidal behaviour, anxiety, and substance abuse (21.3%) of which 76.8% was alcohol-related. Gender and age differences within diagnostic subgroups were identified. For example, substance abuse was more prevalent for men, while anxiety was more prevalent for women. Conclusion. Psychiatric illness and substance misuse have relatively low presentation rates at Norwegian casualty clinics, compared with established daytime attendance at general practitioners. However, the prevalence increases during periods with lowered availability of primary and specialist psychiatric healthcare. These data have implications for the allocation of resources to patient treatment and provide a foundation for future research into provision of emergency healthcare services for this group of patients.

• After-hours care
• emergency medical services
• family practice
• physician's practice patterns
• primary healthcare
• psychiatry