Trend of emergency department presentations with a mental health diagnosis in Australia by diagnostic group, 2004-05 to 2016-17

OBJECTIVE: To examine trends of ED presentations with a mental health (MH) diagnosis in Australia and its jurisdictions by diagnostic group between 2004-05 and 2016-17.  

METHODS: Data comprised ED presentations with a principal diagnosis of ICD-10-AM F00-F99 (MHdx ) captured within the National Non-Admitted Patient Emergency Department Care Database. Trends in absolute number and rates of MHdx presentations per 10 000 population were assessed as differences (x-fold) and annual growth rates (average and compound).  

RESULTS: Increased presentation rates were observed for most diagnostic groups, except for mental retardation (F70-F79) and mood disorders (F30-F39). The greatest absolute increase was for psychoactive substance use-related disorders (F10-F19), and relative increase, unspecified mental disorder (F99). There was differentiation across jurisdictions regarding rates of and growth in presentations. In 2016-17, rates at least twice the national average were observed for psychoactive substance-use (F10-F19), schizophrenia and psychotic disorders (F20-F29) and childhood and adolescence onset disorders (F90-F98) in the Northern Territory, F90-F98 in South Australia, personality disorders (F60-F69) in Tasmania and unspecified mental disorder (F99) in New South Wales. The most marked growth was observed for F99 in New South Wales.  

CONCLUSION: Between 2004-05 and 2016-17, rates of ED presentations increased across most MH diagnostic groups, but particularly psychoactive substance use-related disorders. To reduce the need for MH crisis care in Australian EDs, strategies are required to reduce psychoactive substance use in the community, and policies may be needed to strengthen the capability of community MH services and primary care professionals to recognise, diagnose and treat earlier in the course of illness.