Transcultural Psychiatry
Volume 56, Issue 1, 2019, Pages 167-186

Pathways to and Results of Psychiatric Consultation for Patients Referred from the Emergency Department. Are there Differences between Migrant and Native Patients? (Article)

Gramaglia C. , Gambaro E. , Delicato C. , Di Marco S. , Di Tullio E. , Vecchi C. , Bert F. , Castello L.M. , Siliquini R. , Avanzi G. , Zeppegno P.*
  • a Università del Piemonte Orientale, Italy
  • b Università del Piemonte Orientale, Italy
  • c Università del Piemonte Orientale, Italy
  • d Università del Piemonte Orientale, Italy
  • e Università del Piemonte Orientale, Italy
  • f Università del Piemonte Orientale, Italy
  • g Università degli Studi di Torino, Italy
  • h Università del Piemonte Orientale, Italy
  • i Università degli Studi di Torino, Italy
  • j Università del Piemonte Orientale, Italy
  • k Università del Piemonte Orientale, Italy

Abstract

The aim of this study was to compare migrants and native Italians on the pathways to care and results of psychiatric consultation (PC) in the emergency department (ED). Patients who were referred from the ED for psychiatric consultation (EDPC) at the Maggiore della Carità Hospital between March 2008 and March 2015 were recruited consecutively. Socio-demographic, clinical and consultation variables were recorded along with information about suicidal behaviours; migrants (n = 379; 42.74% males, 57.26% females; age: 45.38 ± 16.95 years) were compared with native Italians (n = 2942; 43.51% males, 56.49% females; age: 42.08 ± 15.89 years). Migrants were younger, more likely to be unemployed and less likely to be already under the care of a psychiatrist. Symptoms related to use of alcohol or substances were more frequent in migrants, especially female migrants. Migrants were less likely than native Italians to be referred for PC because of the presence of psychiatric symptoms, however they were more likely to be referred because of self-harming behaviour. Nonetheless, migrant status was not identified as a risk factor for suicidal behaviour in the multivariate analysis. The outcome of EDPC showed differences between migrants and natives. In absolute terms migrants were less likely to be admitted to a psychiatric ward after the EDPC than native Italians, while they were more likely to be monitored in the ED before being discharged or referred to outpatient care. In a high percentage of psychiatric examinations of migrants, no psychiatric symptoms were identified. Further studies are warranted to disentangle the meaning of these findings. © The Author(s) 2018.

Author Keywords

Suicide attempt emergency department Migrants psychiatric consultation

Index Keywords

hospital admission unemployment mental health service alcohol consumption demography hospital discharge sex ratio human sex difference middle aged suicide attempt statistics and numerical data controlled study comparative study outpatient care Aged Suicide, Attempted substance abuse emergency ward Mental Health Services Mental Disorders mental disease Young Adult Humans migrant mental patient psychology Adolescent consultation male Italian (citizen) female patient referral risk factor Risk Factors Referral and Consultation Multivariate Analysis automutilation Article organization and management Retrospective Studies suicidal behavior major clinical study adult migration Sex Distribution age distribution hospital emergency service Emergency Service, Hospital mental disease assessment Italy Transients and Migrants retrospective study psychiatric department Health Services Accessibility health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058947163&doi=10.1177%2f1363461518798844&partnerID=40&md5=de4644455c1c72a462c2f2afc00b037a
DOI: 10.1177/1363461518798844
ISSN: 13634615
Original Language: English