The following is a summary of “Effectiveness of emergency department-based interventions for frequent users with mental health issues: A systematic review” published in the December 2023 issue of Emergency Medicine by Gabet, et al.

People who use the emergency department (ED) a lot and have mental health problems are especially at risk because they often don’t get enough or proper routine care. The systematic review found and rated studies on ED-based treatments that help this group of people use less emergency care while also making better use of outpatient services and patient outcomes. Five sources were searched for studies that came out between January 1, 2000, and April 30, 2022. Patients with mental health problems who had two or more ED visits in the past six months or who used the ED a lot (3 or more visits per year) and who had ED-based measures to lower their ED use were eligible.

The review looked at 12 studies that looked at 11,082 papers. There were four groups of treatments found: care plans (n = 4), case management (n = 4), peer support (n = 2), and short interventions (n = 2). There were a lot of different ways to describe “frequent users,” and the quality of the studies was rated from “moderate” to “good,” and the risk of bias was rated from “low” to “high.” Four of the studies were randomized controlled trials, and eight used a pre-post strategy. Ten studies looked at results linked to using services other than the ED, mostly stays. Five studies looked at patients’ medical conditions, and three looked at their social conditions, such as their living situation.

The study found that case management and care plan approaches based in the ED help people who use the ED less often. Case management also showed promise for improving clinical and social effects and outpatient service use. So, the results supported keeping intensive ED-based treatments in place for people who use the ED a lot and have mental health problems. However, more research was needed to come to clear conclusions about how well these interventions work, especially when it comes to outcomes that don’t involve ED.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004795