Persons who frequently visit the psychiatric emergency room : who are they and what are their needs?

Persons who frequently visit psychiatric emergency rooms (PERs) account for a disproportionately high number of total visits to PERs. They have needs just as any other human beings do. Yet in addition, they also have specific daily function needs, service needs, and needs for professional healthcare. The overall aim of this thesis was to investigate who persons frequently visiting PERs in Sweden are and what needs they have. Both studies I and II were conducted in southern Sweden. Study I is a quantitative mapping study describing who persons who frequently visit PERs are, what characterizes them, and what characterizes their visits, while study II investigates their self-expressed and selfassessed needs using a mixed-methods design. For data collection, a large-scale registry was used in study I, while in study II an interviewer-administered manual was applied consisting of open-ended questions and validated instruments covering the person-in-care’s needs assessment, alcohol and drug use, exposure to violence, and social network. Quantitative data were analysed using descriptive statistics and non-parametric tests (I, II) and qualitative data were analysed using qualitative content analysis (II). The results indicate that persons who frequently visit PERs represented 8.1% of the total number of PER visitors but accounted for 38.3% of the total number of PER visits (I). They differed significantly from the rest of the PER visitors in terms of gender, diagnoses, hospital admissions, and temporal patterns of visits. Differences were also found in the distance between the PERs and the home municipalities of the visitors (I). In addition, they reported problems in many need areas in life, involving physical and psychiatric health problems as well as financial, emotional, and social problems (II). Results also indicate that they are often subject to violence and have limited social networks (II). The results may be used for planning, developing, and evaluating interventions targeting the needs of persons who frequently visit PERs, which is in line with a person-centred approach. Such an approach might eventually address their needs better, reduce their suffering, and consequently result in fewer PER visits.