Ensuring continuity of care for dual disorder: overview of outpatient services after emergency department discharge
Bibliographic record
Abstract
Despite several existing outpatient services, individuals with dual disorders make extensive use of the emergency department to try to meet their needs. The objectives of this study were to: (1) describe the outpatient services provided to individuals with dual disorders, and (2) compare these services according to the most frequent discharge diagnoses after leaving the emergency department. The frequent discharge diagnoses have been classified into five groups: suicide attempts, psychotic/agitation symptoms, anxiety/depressive symptoms, suicidal ideation, and substance intoxication or withdrawal symptoms. This retrospective cross-sectional descriptive study took place in four emergency department settings in Québec, Canada. Data from emergency department visits and referrals to outpatient services between May 2015 and April 2016 were collected from the medical records of 150 adults with dual disorders. Results showed a low proportion of referrals to primary care or specialized substance use outpatient services; mention of dual disorder in referrals was also rare. Only 19% of individuals received referrals for both mental health and substance use services, suggesting a potential under-recognition of dual disorders. The distribution of services and referrals differed among the five groups, with individuals presenting for suicide attempts and those expressing suicidal ideations accounting for the lowest and highest proportions, respectively.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".