Citation

Brock G, Gurekas V, Gelinas AF, Rollin K. Can. J. Rural Med. 2009; 14(1): 16-20.

Affiliation

Staff Physician, Centre de Sante de Temiscaming-et-de-Kipawa, Temiscaming, Que.

Copyright

(Copyright © 2009, Society of Rural Physicians of Canada, Publisher Canadian Medical Association for the Society of Rural Physicians of Canada)

DOI

unavailable

PMID

19146787

Abstract

Introduction: Little has been published on the management of psychiatric crises in rural areas, and little is known of the security needs or use of"secure rooms"in rural hospitals. Method: We conducted a 3-year retrospective chart audit on the use of our secure room/security guard system at a rural hospital in a town of 3500, located 220 km from our psychiatric referral centre. Results: Use of our secure room/security guard system occurred at the rate of 1.1 uses/1000 emergency department visits, with the most common indication being physician perception of risk of patient suicide or self-harm. Concern for staff safety was a factor in 10% of uses. Eighty percent of patients were treated locally, with most being released from the secure room after 2 days or less. Fourteen percent of patients required ultimate transfer to our psychiatric referral centre and 6% to a detoxification centre. The average annual cost of security was $16 259.61. Discussion: A secure room can provide the opportunity for close observation of a potentially self-harming patient, additional security for staff and early warning if a patient flees the hospital. Most admissions were handled locally, obviating the need for transfer to distant psychiatric referral centres. Most patients who were admitted were already known as having a psychiatric illness and 80% of the patients required the use of the secure room/security guard system for less than a 2-night stay, suggesting that most rural mental health crises pass quickly. Conclusion: Most patients admitted to a rural hospital with a mental health crisis can be managed locally if an adequate secure room/security guard system is available.

Language: en