Are mental health problems associated with use of Accident and Emergency and health-related harm?

Eur J Public Health. 2007 Aug;17(4):387-93. doi: 10.1093/eurpub/ckl248. Epub 2006 Oct 25.


Background: Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole.

Methods: Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm.

Results: Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures.

Conclusion: The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Demography
  • Emergency Service, Hospital / statistics & numerical data*
  • Europe / epidemiology
  • Female
  • Health Status*
  • Humans
  • Male
  • Medical Record Linkage
  • Mental Disorders*
  • Middle Aged
  • Odds Ratio
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / etiology*