Mental and behavioural emergencies at a tertiary healthcare centre in India: Pattern and profile.

ABSTRACT

Background: Sparse data are available on service utilization, pattern and profile of mental and behavioural emergencies in India. We explored the pattern and clinical profile of consecutively referred psychiatric emergencies at a premier tertiary healthcare centre in India. Methods: We reviewed the consecutive referrals for acute mental and behavioural problems made by the emergency department and recorded in an emergency psychiatry register between January 2015 and January 2016. Results: Over a 1 3-month period, 666 patients were assessed; of whom 473 (71 %) had no prior/known psychiatric history and 84 (12.6%) had a comorbid medical condition. Nearly one-third of patients had potential legal issues associated with their emergency. The most common reasons for presentation were an attempt at self-harm (130; 19.5%), aggression/agitation ( 122; 18.3%) and psychoactive substance use-related problems (69; 10.3%). Schizophrenia and other psychotic disorders (89; 13.4%) and mood disorders (87; 1 3.1%) formed the 2 most common diagnostic groups seen in emergency. Most commonly prescribed medications were benzodiazepines (296; 44.4%) followed by antipsychotics (187; 28.1%) and antidepressants (90; 13.5%). Notably, 11% of patients (76) were advised immediate admission under psychiatry, half of whom could be admitted directly from the emergency. Conclusion: Our findings suggest that there is a need to optimize emergency mental healthcare and develop service delivery models for common psychiatric emergencies in India.