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A psychiatric emergency walk-in clinic: a dangerous substitute for primary care?

  • Jane F. Whittaker (a1) and Louis Appleby (a1)
Abstract

Data were collected on a six month sample of patients attending a psychiatric emergency walk-in clinic (n=378), based on the clinical impressions of the interviewing doctor. This information was then compared with a hypothetical model emergency service on the following five items: nature of patient problem, severity of problem, diagnosis, referring agent and current contact with psychiatric services. The severity of the perceived threat to the interviewer was recorded. Only 4.7% of referrals conformed to the hypothetical model on all five criteria. The majority of patients referred themselves, and the problems of self-referrals were significantly less severe than those of general practitioner referrals; 17.2% of consultations were perceived by the interviewing doctor as presenting a moderate or severe threat to his or her safety. The findings suggest that such an emergency facility operates as a form of primary care and is therefore inappropriately used. The level of perceived threat to interviewing doctors is unacceptably high.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (1989) Working for Patients. London: HMSO.
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Royal College of Psychiatrists (1991) Report of the Collegiate Trainees' Committee Working Party on training of junior psychiatrists with respect to violent incidents. Psychiatric Bulletin, 15, 243246.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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A psychiatric emergency walk-in clinic: a dangerous substitute for primary care?

  • Jane F. Whittaker (a1) and Louis Appleby (a1)
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