Older Adults Visiting Emergency Departments for Mental Health Issues
Bibliographic record
Abstract
To describe the characteristics, clinical trajectories, and disposition of older adults consulting in the emergency department (ED) for mental health issues. The secondary objective was to explore the impact of age, sex, and living environment on those patients' clinical care and disposition. This registry study included data from 5 Canadian EDs. Patients were included if they were aged ≥65 years and consulting in the ED between March 1, 2020, and March 31, 2021, for mental health issues. Relative risks (RRs) were obtained using a modified Poisson regression model, and 95% confidence intervals (CIs) were estimated with a robust variance estimator. 1,673 patients were included. The mean ±SD age was 75.2±8.1 years; 58.8% were female, and 87.4% had a prior history of mental health issues. Suicidal ideations (40.8%) and neurocognitive disorders (31.8%) were the most frequent diagnostic impressions. 52.0% were assessed by a psychiatrist, and 49.9% were discharged from the ED. Males were at higher risk of neurocognitive (RR: 1.16 [95% CI, 1.01-1.32]) and substance use disorders (RR: 1.54 [95% CI, 1.19-1.99]). Patients aged ≥85 were more likely to be physically/chemically restrained and less likely to be assessed by psychiatry and hospitalized (RR: 1.69 [95% CI, 1.14-2.50], RR: 0.62 [95% CI, 0.52-0.74], RR: 0.73 [95% CI, 0.57-0.95]). This study highlights that most older ED patients consulting for mental health issues had a prior history of such issues. A psychiatrist assessed most patients, but those aged ≥85 were less likely to be assessed or hospitalized, yet more likely to be restrained. These results should be considered when designing targeted investigations to meet the complex needs of this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".