Abar B, et al. – This study incorporated an analysis of the correlation between anxiety and depression with emergency department (ED) utilization and perceived barriers to care. It was illustrated that patients identified with internalizing mental health concerns utilized the ED at elevated rates, along with reporting the greatest difficulties accessing care. The requirement for ED interventions targeting the detection of patient mental health concerns and perceived barriers to care were outlined in this paper. The intention was to formulate interventions to effectively improve the continuity of care.

Methods

• A convenience sample of adults 45-85 years of age in the ED were surveyed, with the objective of limiting the impact of insurance coverage on ED utilization and access to care.
• The GAD-7 and PHQ-9 estimated anxiety and depression.

Results

• 251 candidates were recruited.
• Severe anxiety was reported in 10% of patients.
• Moderately severe or severe depression was noted in 12% patients.
• Patients who were both severely anxious and depressed visited the ED nearly twice as often as non-anxious and non-depressed patients.
• Maximum patients cited at least one moderate barrier to care, and greater anxiety and depression scores correlating with greater perceived barriers to care.
• Perceived barriers to care were > 3 times higher among patients who were both anxious and depressed, than in those who were neither depressed nor anxious and twice as high as in those who were either depressed or anxious (p<.001).