Frequent Users in Psychiatric Consultations: A 6-Year Retrospective Study in the Emergency Department

Carla Maria Gramaglia (), Eleonora Gambaro, Alessandro Feggi, Amalia Jona, Valentina Zanoli, Francesco Gavelli, Gian Carlo Avanzi, Daniela Ferrante, Silviana Maria Patratanu, Erica Valerio and Patrizia Zeppegno
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Carla Maria Gramaglia: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
Eleonora Gambaro: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
Alessandro Feggi: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
Amalia Jona: Psychiatry Unit Maggiore della Carità University Hospital, Corso Mazzini, 18, 28100 Novara, Italy
Valentina Zanoli: Psychiatry Unit Maggiore della Carità University Hospital, Corso Mazzini, 18, 28100 Novara, Italy
Francesco Gavelli: Emergency Medicine Unit, Maggiore della Carità University Hospital, Corso Mazzini, 18, 28100 Novara, Italy
Gian Carlo Avanzi: Emergency Medicine Unit, Maggiore della Carità University Hospital, Corso Mazzini, 18, 28100 Novara, Italy
Daniela Ferrante: Unit of Medical Statistics, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy
Silviana Maria Patratanu: University of Eastern Piedmont, Via Ettore Perrone, 18, 28100 Novara, Italy
Erica Valerio: University of Eastern Piedmont, Via Ettore Perrone, 18, 28100 Novara, Italy
Patrizia Zeppegno: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17, 28100 Novara, Italy

IJERPH, 2025, vol. 22, issue 6, 1-14

Abstract: The increasing prevalence of emergency room (ER) visits for mental health concerns presents a significant challenge for healthcare systems. This study aimed to analyze the socio-demographic and clinical characteristics associated with frequent users of psychiatric consultations in the ER of Maggiore della Carità University Hospital in Novara, Italy. A retrospective observational study was conducted over a six-year period (2017–2022), including all psychiatric consultations recorded in a hospital database. Frequent users were defined as individuals undergoing at least three psychiatric consultations in the ER within a year. Univariable and multivariable logistic models were employed to identify significant socio-demographic and clinical predictors of frequent use. Of the 1565 individuals who received psychiatric consultations in the ER, 92 (5.88%) were identified as frequent users. Factors associated with higher ER utilization included being unmarried (aOR 1.35, 95% CI 1.02–1.79), younger age (aOR 1.32, 95% CI 1.02–1.72), homelessness, diagnosis of schizophrenia, substance use disorder (aOR 1.49, 95% CI 1.06–2.09), and ongoing psychopharmacological treatment (aOR 1.56, 95% CI 1.12–2.18). These findings highlight the need for targeted interventions to improve care continuity and community-based support for individuals at risk of frequent ER visits for psychiatric reasons.

Keywords: emergency service; hospital; frequent users; health services misuse; mental health; socioeconomic factors; demography; psychiatric consultation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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