: Medical emergency department utilization patterns among uninsured patients with psychiatric disorders. During the study period, 49,354 patients were treated in the ED (Table 1) and included in analysis. This work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (grant KL2TR000421 to Dr. Moore). All analyses were done with SAS 9.3 and Stata 10. In addition to providing mental health services to patients, social workers provided crisis counseling to family or friends of critically ill or incapacitated patients (counted in mental health services). A count variable was created documenting ED visits (including index) for each patient during the study period. The authors report no financial relationships with commercial interests. In 2010, psychosis was one of the top 20 diagnostic groups for ED visits for men ages 15–65 (13). International Scientific Journal & Country Ranking. Also, this study was done at a single, urban, academic trauma center with a dedicated psychiatric emergency service and thus may not be generalizable to settings that are not trauma centers. Injury (codes 800.0–801.9, 803.0–804.9, 850.0–854.1, and 959.01) was also analyzed separately because of its relevance to social work services. There is a paucity of research on ED social work services despite the important role of social workers on interdisciplinary teams (4). Healthcare Cost and Utilization Project Statistical Brief 92:1–12, 2006Google Scholar, 13 National Hospital Ambulatory Medical Care Survey. Regression model of predictors of receipt of social work services by patients seen in an emergency department (ED). Introduction. Mental Health and Social Inclusion (MHSI) is primarily written by practitioners for practitioners working to promote the social inclusion of people with mental health conditions. We initially assessed the demographic, diagnostic, discharge, and visit count information for the entire cohort. Probably because of illness complexity and severity and the related high level of patient need, as well as patient flow and prioritization in the trauma center ED, social workers were more likely to see patients who were not discharged home, arrived by EMS, and had comorbid diagnoses or an injury. Introduction Social workers are among the largest group of professionals in the mental health workforce and play a key role in the assessment of mental health, addictions and suicide. : Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002–2006. Show all authors. Journal of Health and Social Behavior, 51 ... She/he does not attend school or go to work. The Journal Impact Quartile of Social Work in Mental Health is Q2. Wallace, J., & Pease, B. Social workers are often referred the most complicated patients who require mental health, social, and referral services in order to be discharged (7,14,15). Social Work in Health Care 44:17–32, 2007Crossref, Medline, Google Scholar, 16 Faul M, Xu L, Wald MM, et al. Discharge disposition was entered into the EMR by the treating ED provider. Comprehensive reviews were conducted of medical records of all patients (N=49,354) treated in a level 1 trauma center ED from January 1, 2012, to March 31, 2013. Social capital and mental health - Volume 181 Issue 4 - Kwame McKenzie, Rob Whitley, ... Social ties and mental health. If discrepancies arose, the coding team discussed coding choices until 100% agreement was reached. Future studies could examine the cost-benefits of providing social work services and the impact of these services on care coordination. Subscribe. This was a cross-sectional study of all patients treated in the ED of a large, urban, academic, level 1 trauma center from January 1, 2012, to March 31, 2013 (N=49,354). It has been demonstrated that the majority of patients seen by social workers in the ED are discharged home rather than admitted (7). All Journals Social Work in Health Care List of Issues Volume 59, Issue 8 2019 Impact Factor. Register, Oxford University Press is a department of the University of Oxford. Females, patients not discharged home, and patients arriving by emergency medical services (EMS) had a higher likelihood of receiving social work services compared with males, those discharged home, and those not arriving by EMS (Table 3). Triage algorithms are needed to target efficiencies, systematize provision of ED social work services, and improve access to services for all patients. Each note was given a title by the social worker with a brief description of the service provided. Other possible contributors to the increased length of stay include lack or limited availability of community resources. Many patients seen by social workers were discharged home (42%). Nurse Researcher 4:5–16, 1997Medline, Google Scholar, 28 Zou G: A modified Poisson regression approach to prospective studies with binary data. Injury etiology was further classified by using the Centers for Disease Control and Prevention–recommended framework of E-code groupings in the Web-based Injury Statistics Query and Reporting System (23): unintentional injury (E800–E869 and E880–E929), self-inflicted injury (E950–E959), assault (E960–E969, E979, and E999.1), and undetermined (E980–E989). Specifically, more than one-quarter of the 2.8 million intentional injuries treated in EDs were self-inflicted, and nearly one-third of the 2.7 million patients transferred from EDs to other hospitals were transferred to a psychiatric hospital (13). Mick McCormick. (2011). https://www.caradigm.com/en-us/solutions-for-population-health/intelligence-platformGoogle Scholar, 23 Matrix of E-code Groupings. Providers need easily accessible and rapidly applicable triage algorithms to consistently refer all patients with social work needs. Science 343:263–268, 2014Crossref, Medline, Google Scholar, 40 Smulowitz PB, Lipton R, Wharam JF, et al. Compared with historical Journal Impact data, the Metric 2019 of Social Work in Mental Health grew by 32.76%. JAMA 304:664–670, 2010Crossref, Medline, Google Scholar, 6 Mahajan P, Stanley R, Ross KW, et al. They receive referrals via pager and from staff directly. Specifically, the following categories were included: anxiety and acute stress disorders (including posttraumatic stress disorder, 309.81; acute stress disorders, 308.0–308.9; adjustment disorders, 309.0–309.9; panic disorder, 300.01, 300.21, and 300.22; phobia, 300.29; social anxiety, 300.23; obsessive-compulsive disorder, 300.3; generalized anxiety disorder, 300.02; and other anxiety, 293.84, 300.00, 300.09, 300.2, and 313), depressive disorders (including major depressive disorder, 296.2–296.99; dysthymia, 300.4; and other depressive disorders, 309.1 and 311), psychotic disorders (including schizophrenia, 295.0–295.99; bipolar disorders, 296.0; and psychosis not otherwise specified, 300.9). Patients could receive more than one service during their visit. Hyattsville, Md, National Center for Health Statistics, 2010Google Scholar, 14 Auerbach C, Mason SE: The value of the presence of social work in emergency departments. Enter your email address below and we will send you the reset instructions, If the address matches an existing account you will receive an email with instructions to reset your password, Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. British Journal of Social Work, 33, 1081 – 1103 . Atlanta, Centers for Disease Control and Prevention, 2010. http://www.cdc.gov/injury/wisqars/ecode_matrix.htmlGoogle Scholar, 24 Kessler RC, Chiu WT, Demler O, et al. New content alerts RSS. Social work, mental health, older people and COVID-19 - Volume 32 Issue 10 Skip to main content Accessibility help We use cookies to distinguish you from other users and to provide you with a better experience on our websites. : Alcohol and drug use disorders among adults in emergency department settings in the United States. The University of Washington Institutional Review Board approved the study. Social workers documented each patient encounter in the EMR. Health is defined broadly to include both physical and mental health. doi: 10.1093/bjsw/33.8.1081 Demographic characteristics available in the EMR included age, sex, primary language, and race-ethnicity. One investigator (MM) read and coded the first 500 note titles to develop the data-driven initial codebook. The World Health Organization has pointed to depression as a leading cause of the disease burden (measured in disability-adjusted life years) in middle- and high income countries .. Working in multidisciplinary community mental health teams: The impact on social workers and health professionals of integrated mental health care. The editorial board welcomes manuscripts on all aspects of health that are of professional concern to social workers. Over 80% of the more than 1.3 million patients seen in EDs nationally for traumatic brain injury (TBI) were discharged home (16). Please check your email address / username and password and try again. American Journal of Emergency Medicine 26:155–164, 2008Crossref, Medline, Google Scholar, 32 Educational Policy and Accreditation Standards. 1 Almgren G, Lindhorst T: The Safety Net Health Care System. : Rates of major depressive disorder and clinical outcomes following traumatic brain injury. Types of services provided by social workers to patients seen in an emergency departmenta. TABLE 1. During the study period, 15 of 20 social workers were licensed clinical social workers. EDs are increasingly serving patients with multifaceted needs. 0.982 ... Social Work in Health Care, Volume 59, Issue 8 (2020) Research Article . Mental health problems represent an increasingly important public health challenge. JAMA 299:70–78, 2008Crossref, Medline, Google Scholar, 36 Love J, Zatzick D: Screening and intervention for comorbid substance disorders, PTSD, depression, and suicide: a trauma center survey. See all articles by this author. The U.S. National Hospital Ambulatory Medical Care Survey (NHAMCS) consistently documents high prevalence rates of ED patients with needs potentially amenable to social work services, including patients with mental or substance use disorders and patients who are homeless, poor, or unable to access outpatient services (20). : Medicaid increases emergency-department use: evidence from Oregon’s Health Insurance Experiment. Poverty, social inequality and mental health - Volume 10 Issue 3 Skip to main content Accessibility help We use cookies to distinguish you from other users and to provide you with a better experience on our websites. 82, Social Work in Health Care, Vol. This multidisciplinary journal focuses on recovery-oriented care of persons with mental health problems and on their rehabilitation. : Emergency department utilization after the implementation of Massachusetts health reform. Future studies should incorporate these characteristics. European Journal of Social Work, Vol. An increase in the number of comorbid diagnoses was associated with an increased likelihood of receiving social work services. Annals of Emergency Medicine 58:225–234, 2011Crossref, Medline, Google Scholar, 41 Andrews CM, Darnell JS, McBride TD, et al. Other factors to consider include examination of existing triage procedures and data elements and inclusion of priority populations to meet social work’s social justice mission. This article proposes a framework to strengthen mental health social work practice by outlining subjective wellbeing, a component of the QOL construct. We then determined predictors of social work services by estimating relative risk (RRs) and 95% confidence intervals (CIs) for receiving social work services by using unadjusted Poisson regression with robust standard error variance to determine univariate associations (28). New ... Browse the list of issues and latest articles from Social Work in Mental Health. Seattle, Caradigm. Journal of Pediatrics 165:618–621, 2014.Crossref, Medline, Google Scholar, 34 Pines JM, Russell Localio A, Hollander JE: Racial disparities in emergency department length of stay for admitted patients in the United States. Journal of the American College of Surgeons 219:505, 2014Crossref, Medline, Google Scholar, 39 Taubman SL, Allen HL, Wright BJ, et al. Such services were associated with an increased length of ED stay (RR=1.34). All Journals Social Work in Mental Health List of Issues Volume 18, Issue 6 Social Work in Mental Health. Journal of Health and Social Behavior (JHSB), published quarterly, is a medical sociology journal that publishes empirical and theoretical articles that apply sociological concepts and methods to the understanding of health and illness and the organization of medicine and health … Mental health is a field of medicine and science that has been gaining traction, since it’s been addressed as a priority by a myriad of medical scholars and experts. The same analytic process was used to assess predictors of length of stay. Her starting point is that mental health is a key element of all areas of social work practice and that social work has made a particular contribution to mental health thinking and practice. : The impact of race on analgesia use among pediatric emergency department patients. To purchase short term access, please sign in to your Oxford Academic account above. Most were mental health services (54%), followed by care coordination (31%) and material support or other referrals (15%). Psychiatric Services 65:918–923, 2014Link, Google Scholar, 37 Russo J, Katon W, Zatzick D: The development of a population-based automated screening procedure for PTSD in acutely injured hospitalized trauma survivors. Then we compared the characteristics of patients who received social work services during their ED visit and those who did not. In this investigation, we excluded the category “symptoms, signs and ill-defined conditions” because of the broad, ill-defined nature of this category. Most social workers provide services to individuals with mental health concerns, yet there are gaps in research on social work education and training programmes. Social workers in trauma center EDs are providing mental health services, care coordination, and material support and other referral services to patients with multifaceted needs resulting from complex mental and substance use disorder diagnoses, trauma, and comorbid diagnoses. : Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Despite these contributions, ED social work remains an understudied and underfunded area of emergency medical services (4). Legal knowledge and an ability to understand how and when to intervene are both necessary and appropriate in forensic settings. The coding team (MM, DD, and LH) then met and discussed codes that were included in the final codebook. Previous studies have been limited by small samples or by a focus on specific populations (6) or interventions (30,31). Non-English speakers, patients not discharged home, and those with comorbid diagnoses had a higher risk of a longer ED stay (Table 4). Compared with their population percentage in the county, whites and Asians were underrepresented in the ED patient population (76% versus 53% and 14% versus 9%, respectively), and African Americans (6% versus 22%), Hispanics (7% versus 8%), and American Indians (1% versus 2%) were overrepresented (29). There may be intrinsic personal factors, combined with familial, psychological, economic, health, educational, employment, TABLE 2. Finally, this study did not explore the effects of preexisting diagnoses or visit history on receipt of social work services or length of ED stay or cost-effectiveness of services. The use of Quality of Life (QOL) indicators has become increasingly common in health and social services. Expanding social work capacity and roles in the ED may be crucial to support ACA mandates for coordinated care. Characteristics of patients seen in an emergency department (ED), by whether they received social work services in the ED. Annals of Emergency Medicine 41:802–813, 2003Crossref, Medline, Google Scholar, 10 Wu LT, Swartz MS, Wu Z, et al. Although social work services marginally increased length of ED stay, social workers provided multiple services to patients with complex presentations. This article reviews the social work literature on ICT, draws on research on tele-psychology and tele-education, and provides suggestions on how to enhance engagement with ICT by social workers to implement and provide mental health services and supports tailored to community values, needs, and preferences that are commensurate with the values of the social work profession. Content analysis of chart notes was used to categorize the types of social work services provided. : Evaluation of an emergency department-based enrollment program for uninsured children. With training in mental health, substance abuse, and injury-related services, social workers can serve as frontline providers for many of these patients. American Journal of Epidemiology 159:702–706, 2004Crossref, Medline, Google Scholar, 29 The Greater Seattle Datasheet. Journal Impact 2018 di Social Work in Mental Health è 0.770 (Ultimi dati nel 2019). Archives of General Psychiatry 62:617–627, 2005Crossref, Medline, Google Scholar, 25 Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Journal of Teaching in Social Work, 31(3), 278–294. Patients with TBI have high rates of comorbid mental illness (17–19), and many would benefit from early intervention and identification by social workers. Next, backward elimination was used to delete variables from the model that were not significant at p<.05 in order to determine adjusted RRs and CIs. The Journal Impact 2019-2020 of Social Work in Mental Health is 0.770, which is just updated in 2020. Social work services provided to patients seen only in the psychiatric emergency service were not included in analyses because of the nature of the way those notes are entered, which likely resulted in an underestimation of number of mental health services provided.
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