Behavioral Health Emergency Department Visits Increased 26% From 2005 To 2011

Between 2005 and 2011, the number of hospital emergency department visits for mental health and substance use disorders increased by 25.8%, from 27.9 visits per 1,000 in 2005 to 35.1 visits per 1,000 in 2011. Homeless persons and nursing home residents had the highest rates of such visits in 2011. The rate for homeless persons was 173.7 per 1,000 emergency department visits. The rate for nursing home residents was 95.2 per 1,000 emergency department visits.

These findings were reported in “Characteristics of Hospital Emergency Room Visits for Mental and Substance Use Disorders,” by Toluwalope Ayangbayi, M.Sc., M.D.; Albert Okunade, M.S., Ph.D.; Mustafa Karakus, M.A., Ph.D.; and Thierry Nianogo, M.Sc., Ph.D. The researchers analyzed pooled data comprising 193,526 observations from National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005 to 2011.

The goal was to compare characteristics of visits to emergency rooms (ERs) for mental and substance use disorders and for physical health conditions to establish a baseline against which to measure changes after full implementation of the Patient Protection and Affordable Care Act (PPACA) of 2010 and parity legislation. Additional findings were as follows:

• From 2005 to 2011, the number of emergency department visits for mental and substance use disorders increased significantly for all age groups over six years. The increase was highest, 29%, for the 25- to 44-year group, rising from 32.7 per 1,000 emergency department visits in 2005 to 42.3 per 1,000 emergency department visits in 2011.

• The trend was consistent for both males and females. The rate for males increased 17.6%, from 32.9 per 1,000 visits in 2005 to 38.7 per 1,000 visits in 2011, and the respective increase for females was 38.0%, rising from 23.7 per 1,000 emergency department visits in 2005, to 32.2 per 1,000 emergency department visits in 2011.

• Compared with people with private insurance, uninsured people were 1.30 times more likely to visit the emergency department for a mental health or substance use disorder. Medicare enrollees were 1.66 times more likely to make such a visit, and Medicaid beneficiaries were 1.65 times more likely.

• People who had been discharged from a hospital within the past seven days were 1.49 times as likely as those who had not been discharged in the past seven days to make an emergency department visit for mental and substance use disorders.

The researchers concluded that the populations making emergency department visits had a variety of reasons for the visit. The researchers recommended that more effective policies for guiding emergency department intake could be helpful.

The full text of “Characteristics of Hospital Emergency Room Visits for Mental and Substance Use Disorders” was published in the April 2017 issue of Psychiatric Services. A free abstract is available online at https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201600125 (accessed May 3, 2017).

For more information, contact: Albert Okunade, Ph.D., Professor, Department of Economics, University of Memphis, 3720 Alumni Avenue, Office BA 450, Memphis, Tennessee 38152; 901-678-2672; Email: tyngbayi@memphis.edu; Website: https://www.memphis.edu/.

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