By Greg Basky for Saskatchewan Health Research Foundation (SHRF)
In Saskatchewan, some people with mental health and addictions problems are frequent visitors to the Emergency Department (ED). A study published in 2017 found that among the more than 1,200 people who visited Emergency at least once between April 2012 and March 2013, close to 60% went between one and three times, 25% visited four to seven times, and 18% were there more than eight times.
For University of Saskatchewan nursing professor and researcher Dr. Hua Li, what’s been missing from the conversation about how best to meet this patient group’s needs is the perspective of the frequent ED visitors themselves, as well as input from their caregivers and health care providers. As a result, policy makers are without key information they could use to develop programs that help manage many individuals’ symptoms in the community. With the support of a SHRF Establishment grant, Li is aiming to fill this gap. “If we can find ways to help patients in the community, before the deterioration of their symptoms, they can maintain their functioning and enjoy life.”
In the first phase of the research project, Li and her team will survey clients by phone or Webex to find out how frequently they visit Emergency, what community programs they do and don’t use -- and why -- and to gather suggestions for other resources that would help them stay well. Li is interested to see how infrequent visitors differ from frequent visitors in their use of community resources. “Maybe we’ll find that you need to encourage this group to do the same thing as the other group.” Li is collaborating with the Schizophrenia Society of Saskatchewan and the Saskatchewan Health Authority’s Mental Health and Addiction Services.
The second stage of the project will involve in-depth interviews conducted virtually with survey respondents who reported visiting Emergency more than five times in the previous year. Phase two will also include focus group discussions with caregivers of frequent users and health care providers working with patients who visit the ED frequently.
Li expects to share what they learn about possible service gaps and ways to enhance community supports with the SHA and Ministry of Health by fall 2023. “Even if we could reduce the number of visits (to Emergency) by 10 per cent, it would be very significant,” says Li. “We would save human suffering. Before they’ve gone to the ED, we’ve already helped them with the issues they may have. And it would save the health system money.”