Frequent attenders with mental disorders at a general hospital emergency department


  • Michael DG Wooden, BSW, Senior Social Worker; Tracy M Air, BA(Hons), Research Officer; Geoffrey D Schrader, MB BS, PhD, Senior Lecturer; Barbara Wieland, M Advanced Prac, General Manager; Robert D Goldney, MB BS, MD, Head.

Ms Tracy M Air, Discipline of Psychiatry, Level 4 Eleanor Harrald Building, Royal Adelaide Hospital, The University of Adelaide, Adelaide, SA 5005, Australia. Email:


Objectives:  To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders.

Method:  A retrospective descriptive study of those who attended the Queen Elizabeth Hospital, Woodville South, Australia ED on average at least once per month between 1 July 2006 and 15 March 2007.

Results:  Of 11594 attenders, 54 (0.47%) at the ED were frequent attenders with mental disorders. Their 735 attendances represented 4.5% of the total of 16 345 attendances. Of those frequent attenders, 34 (63%) also visited other Adelaide hospital ED on an additional 410 occasions. Presentations peaked on the weekends and between 18.00 h and midnight. Although 43% of frequent attenders had specific mental health-care plans, only two-thirds of those had been assigned to a mental health team.

Conclusions:  The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.