Abstract

Objectives: This study was carried out to assess availability of psychiatric emergency services for patients presenting to Imam-Hossein and Taleghani Hospitals in Tehran which inspite of admission need, are not admitted, and role of hospital bed shortage in it with associated risk of suicide in these clients if not admitted.

Method: This cross-sectional descriptive study lasted from October 2004 to January 2005 in these two hospitals. On-call psychiatry residents interviewed all patients referred to the Psychiatry Emergency Units in a 24-hour period and data were documented in the questionnaires.

Results: A total of 426 patients (347 in Imam-Hossein and 79 in Taleghani hospitals) were studied. Mean age of the clients was 32.8 years 50.2% were male and 49.8% were female 77.9% of all needed admission, 44.6% of those which were not admitted 39.1% had moderate or high risk of suicide. Cause of non-admission was lack of hospital beds in 93.2% of cases. Parameters such as diagnosis (psychotic or mood disorder), longer duration of illness, higher risk of suicide and history of suicide attempt, though in more need of being admitted, didn’t relate significantly with admission probability. Besides, patients with substance abuse and those with more recent suicide attempt, though in more need of being admitted, were significantly less admitted (p<0.001) those who needed to be admitted because of risk to harm self and/or others, were significantly less admitted than other patients. In logistic regression analysis only two factors of gender (female) and education correlated significantly (p-value of 0.001 & 0.05 respectively) with admission probability in case needed (with odd ratios of 2.63 and 0.93, respectively).

Conclusion: It seems that there is a serious lack of necessary hospital beds for patients and the need for admission doesn’t determine admission probability.