Use of Emergency Rooms for Mental Health Reasons in Quebec: Barriers and Facilitators

Adm Policy Ment Health. 2019 Jan;46(1):18-33. doi: 10.1007/s10488-018-0889-3.


This study explored barriers and facilitators in mental health (MH) patient management in four Quebec (Canada) emergency rooms (ERs) that used different operational models. Forty-nine stakeholders (managers, physicians, ER and addiction liaison team members) completed semi-structured interviews. Barriers and facilitators affecting patient management emanated from health systems, patients, organizations, and from professionals themselves. Effective management of MH patients requires ER access to a rich network of outpatient, community-based MH services; integration of general and psychiatric ERs; on-site addiction liaison teams; round-the-clock ER staffing, including psychiatrists; ER staff training in MH; and adaptation to frequent and challenging ER users.

Keywords: Barriers; Emergency rooms; Facilitators; Mental health patient management; Qualitative methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Community Mental Health Services / organization & administration
  • Continuity of Patient Care / organization & administration
  • Emergency Service, Hospital / organization & administration*
  • Emergency Services, Psychiatric / organization & administration
  • Female
  • Health Services Accessibility / organization & administration
  • Humans
  • Inservice Training / organization & administration
  • Interviews as Topic
  • Male
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Middle Aged
  • Patient Care
  • Qualitative Research
  • Quebec
  • Socioeconomic Factors
  • Substance-Related Disorders / therapy