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Psychiatric presentations to an A&E department

Waterlow Unit, Camden and Islington Community Health Services NHS Trust, Highgate Hill, London N19 5NF

Simon Lewis, Registrar in Psychiatry

^* Correspondence

A survey is described of people presenting with psychiatric problems to a north London accident and emergency (A&E) department over three months. Forty per cent presented with deliberate self-harm and 25% of these left before being assessed. Twenty per cent of those with problems compatible with a diagnosis of severe mental illness also left before being seen by a doctor. Differences between presentations ‘out-of-hours’ and ‘in-hours’ are described. Factors predicting admission were: previous psychiatric admission, symptoms of a psychotic or affective disorder and non-permanent accommodation. The survey has implications for the process of triage in A&E departments and the organisation of mental health liaison services.