How often do you get psych pt self walk ins

JessicaER-RN · Nov 8, 2011

You might get more replies if you post in the Emergency Nursing forum.

But to answer your question, I'd say MOST of the time they are brought in by someone else, especially if it is something serious (suicide attempt, threatening others, acting erratically, non-compliant with psych meds, etc). Most of the walk in's who are by themselves are there for anxiety or depression without suicidal ideation.

As for numbers, my ER averages 7 psych patients per day. I don't know the breakdown of walk in VS ambulance/police/other.

Your second question sounds like how often when get suicide attempts that are overdoses. It is pretty rare for someone to bring themselves in after they have overdosed (or in the process of it). Either they are found by a family member or friend, or the patient themself calls someone as a cry for help, and then that person calls 911. Or they are brought in as a code.

This situation probably happens about 4-5 times a week (?).

It really depends on the moon's pattern

elkpark · Nov 8, 2011

In my experience in psych consultation-liaison over the years, a large proportion (although I certainly can't quote any numbers -- but I would estimate at least 50%, if not more) of the psych people showing up in the ED of the hospitals in which I've worked have come in on their own seeking help.

Of course, they have often been "brought in by someone else" in the sense that they called 911 or a friend or family member actually drove them to the ED, but I'm talking about people who are coming in of their own choice and asking for help, not people being forcibly brought in against their will.

Esme12, ASN, BSN, RN · Nov 8, 2011

How often do you get psych patients who bring themselves into the er.... is it a common occurance or are they mostly brought in by someone else or by authorities? What is the percentage of self walkins vs having someone(police/abulance/family member/spouse) bring someone in. What about people who claim to have already done something potentially harmful and then coming in (ei after ingesting something deliberately)
I'm just wondering how often everything it occurs and what percentage or which is more common. Im just curious.

Here in the US the Mental Health system is in shambles with cut backs on reimbursements from the government the hospitals have closed many of their inpatient facilities and our "public" facilities/institutions have long since closed due to financial failure. The population served by these facilities have been left to fend for themselves.

A huge portion of psych patients come to the ED system in the US by walking in, police, ambulance. Whether they are SI, HI or dancing naked in the middle of Times square....they are brought to the ED. Every drunk driver public intox/nusience are also brought to the ED to be "evaluated" and/or sobered up. Many "voluntary" detox's come intoxicated from their last binder before rehab for "medical clearance" and have to wait until they have a blood alcohol to go below 100/0.1 before being admitted.....many will sit in the ED awaiting bed placement for DAYS before a bed opens.

Many places have only a limited number or "charity/welfare" beds available so these patients sit and wait. :mad: Suicide patients are seen in the ED and must be "medically cleared/stable" before they can be accepted by an inpatient facility and at times wait for a bed to open for days.....sometimes these patients are also kept in the ED for days..

It's a system in crisis and like everything else.....it lands in the ED

Altra, BSN, RN · Nov 8, 2011

I would say nearly 75% are self-walkins or have otherwise initiated some course of action, i.e., calling 911 after taking a handful of pills.

chimpanzee · Nov 9, 2011

thanks for the responses

and also thnks for being patient with my stupid questions. i appreciate it.

Meriwhen, ASN, BSN, MSN, RN · Nov 9, 2011

At my old facility, we'd get quite a lot of walk-ins via ED. We'd also get quite a lot of walk-ins via our lobby, who we send to the ED to get medical clearance (if necessary).

The only stupid questions are the the ones that aren't asked :) Remember that.

ccoombs · Nov 14, 2011

I work in a state hospital and we get almost no voluntary admissions.

elkpark · Nov 14, 2011

I work in a state hospital and we get almost no voluntary admissions.

That's a v. different situation from a community hospital ED. However, I have taught psych clinical in the past in one state hospital that got quite a few voluntary admissions, and I currently work for a facility that serves as the "state hospital" for our region (weird situation -- the state closed the state hospital, and this facility contracted with the state to agree to take the people who would have gone to the state hospital) and it gets lots of walk-in, voluntary admissions.

aloevera · Nov 14, 2011

I would guess that 75% come in via police from hospital......BUT...

I have had schizo/suicidal pts. walk-in, and brought in by family/friends.........maybe 25%........one rode his bicycle in last week !!!