Prevalence of Impairing Behavioral Health Problems in ED Patients and Association with ED Utilization

Background: It has been observed that patients with poor mental health are relatively frequent users of the Emergency Departments (ED). The objective of this study was to evaluate the prevalence of numerous behavioral health domains (depression, anxiety, PTSD, substance abuse, and suicidality) in patients presenting to the IU Health Methodist Emergency Department. Methods: This study seeks to enroll 1000 English-speaking adults presenting to Methodist and Eskenazi ED. Patients were assessed for behavioral health problems using the CAT-MHTM, PHQ-8 and GAD-7 screening tools. Data on disposition medical history, discharge diagnoses, and ED utilization in the 12 months before and 30 days after enrollment from EMR and INPC will be reviewed. Results: 375 patients have been enrolled. Of those 59.4% were female with an overall mean age of 46.1 (SD ± 16.4). CAT-MH results showed 216 (57.8%) had no depression, 158 (42.2%) had mild-severe depression, while 263 (70.3%) had no anxiety and 111 (29.7%) had mild-severe anxiety. Inter-rater reliability for CAT-MH, GAD-7 and PHQ-8 was about 0.80 for a 95% CI. Conclusion: In our sample, almost half of patients that visit the ED have screened positive for mental health problems. We believe that early identification and appropriate referral may reduce inappropriate ED utilization