Identifying and managing multimorbidity in Emergency Department patients presenting with mental health crisis.
Supervisors:
Professor Frances Quirk, School of Medicine, University of St Andrews
Professor Colin McCowan, Population and Behavioural Sciences Division, Medical School (University of St Andrews)
Dr Sarah Mills, Population and Behavioural Sciences Division, Medical School (University of St Andrews)
Dr Rajendra Raman, NHS Fife
Summary:
The association between physical multimorbidity and mental health disorders is well-documented, with good evidence to show that each can worsen the other. The Emergency Department (ED) is a key healthcare access point for people experiencing both physical and mental health crises. Socially disadvantaged populations may use EDs as their primary or only source of healthcare, thus a mental health-related ED attendance may represent a valuable opportunity to identify a vulnerable, underserved group whose multimorbidity would otherwise go unrecognised.
Phase 1 of this PhD will use quantitative methods to estimate the number of patients presenting to ED with mental health issues who are living with multimorbidity, to map these patients’ usage of scheduled and unscheduled healthcare, and to examine social deprivation indices and healthcare usage patterns in this patient cohort.
Phase 2 will be a qualitative study using thematic analysis of semi-structured interviews to explore the barriers experienced by these patients in accessing primary and secondary healthcare.
In Phase 3, the student will use knowledge gained in Phases 1 and 2 to design and pilot one or more interventions to improve access to physical and mental health services for patients following a mental health-related ED attendance.