Demand and characteristics of a psychiatric 24-hour emergency service performed by mandatory rotation of licensed psychiatrists in Swiss primary care

Figures & data

Table 1 Inquiry distribution over the EMST switchboard

Inquiry by	Absolute n (Total n=291)	% of consultations
Police	44	15.1
Family member	43	14.8
Patient	34	11.7
General practitioner	8	2.7
Medical attendant	8	2.7
Residential home/old age home/nursing home	8	2.7
Social worker/social welfare office/youth welfare office	5	1.7
Home nurse care/nurse	5	1.7
Psychiatric clinic/hospital	5	1.7
Ambulance service/emergency doctor	5	1.7
Neighbor	4	1.4
Psychiatrist	3	1.0
Employment office	2	0.7
Employer	2	0.7
Lawyer	2	0.7
Emergency overnight accommodation	1	0.3
Coworker	1	0.3
Public transport institution	1	0.3
Shelter home	1	0.3

Abbreviation: EMST, Emergency Medical Service Telephone.

Table 2 Clinical details on direct patient encounters

Clinical characteristic (total n=189)	Value
Sex (male), %	50.3
Age, years (n=182), mean (SD)	44.1 (18.3)
Problem solved on location, %	49.2
Arranged outpatient therapy, %	15.9
Involuntary hospitalization, %	50.3
Police requested, %	14.3
Ambulance requested, %	34.4
Medical judgment of imprisonment ability, %	5.3
Oral medication, %	13.8
Parenteral medication, %	0.0

Note: Multiple responses can sum up to >100%.

Abbreviation: SD, standard deviation.

Table 3 Distribution of diagnoses according to ICD-10

ICD-10	Diagnosis	Frequency	% responses	% of cases
F20	Schizophrenia	43	23.91	31.21
-	Suicidal	28	15.22	19.86
F43	Reaction to severe stress, and adjustment disorders	19	10.26	13.49
F32	Depressive episode	12	6.48	8.52
F60	Specific personality disorders	11	5.94	7.81
F10	Mental and behavioral disorders due to use of alcohol	11	5.94	7.81
-	Self-endangerment	8	4.35	5.67
X84	Intentional self-harm by unspecified means	6	3.26	4.26
F25	Schizoaffective disorders	6	3.26	4.26
F03	Unspecified dementia	6	3.26	4.26
F30	Manic episode	6	3.26	4.26
F31	Bipolar affective disorder	4	2.17	2.84
F41	Other anxiety disorders	3	1.63	2.13
Y49	Complications due to use of psychotropic drugs	2	1.09	1.42
-	Assessment of mental fitness for imprisonment	2	1.09	1.42
F33	Recurrent depressive disorder	2	1.09	1.42
F19	Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances	2	1.09	1.42
F40	Phobic disorders	2	1.09	1.42
F05	Delirium, not induced by alcohol and other psychoactive substances	1	0.54	0.71
F22	Persistent delusional disorders	1	0.54	0.71
F42	Obsessive–compulsive disorder	1	0.54	0.71
F51	Nonorganic sleep disorders	1	0.54	0.71
F79	Unspecified mental retardation	1	0.54	0.71
F90	Hyperkinetic disorders	1	0.54	0.71
-	Involuntary hospitalization	1	0.54	0.71
R33	Retention of urine	1	0.54	0.71
R40	Somnolence, stupor, and coma	1	0.54	0.71
Z63	Other problems related to primary support group, including family circumstances	1	0.54	0.71

Note: Sum >100% due to the possibility of multiple diagnoses per patient -, no corresponding ICD-10 code available.

Abbreviation: ICD-10, International Classification of Diseases, version 10.

Table 4 Physicians’ level of pressure during, and satisfaction with, the current emergency service (n=40)

	Completely disagree (%)	Disagree (%)	I don’t know (%)	Quite agree (%)	Completely agree (%)
I am tense during emergency services	2.56	15.38	7.69	35.90	38.46
I often encounter dangerous situations during emergency services	5.00	35.00	12.50	30.00	17.50
I feel burdened by encountered cases	5.00	27.50	5.00	45.00	17.50
I like to provide emergency services	25.00	27.50	12.50	25.00	10.00
I am satisfied with the organization of the emergency service (EMST)	2.50	7.50	0.00	25.00	65.00
I am satisfied with the current emergency service duty hours	15.00	7.50	35.00	22.50	20.00

Abbreviation: EMST, emergency medical service telephone.

Table 5 Problems with the emergency service

Problems with handover (%) (n=40)
Often	0.00
Seldom	40.00
Never	60.00
Bills not paid (%) (n=37)
Often	32.43
Seldom	54.05
Never	13.51
Practice closed (%) (n=42)
Completely	95.24
Partially	4.76
Open	0.00
Service provided (%) (n=42)
Alone	85.71
With colleague	11.90
With other support	2.38