Original Title: Utilisation fréquente des services d’urgence par les usagers ayant un trouble mental

Authors' objectives: In a recent report, the Auditor General of Quebec (AGQ) highlighted challenges in meeting the needs of individuals with mental disorders, particularly regarding the continuity of care and services. The AGQ and the Committee on Public Administration also emphasized the lack of common criteria for identifying and monitoring individuals with mental disorders who use emergency departments frequently. In this context, the MSSS mandated INESSS to examine the frequent use of emergency services. Work conducted in 2024 provided a general profile of individuals who frequently use emergency departments based on Quebec clinical-administrative data. Building on this earlier work, INESSS produced the present report of practices, which aims to better understand frequent emergency department use among individuals with mental disorders and to identify best practices for addressing their needs in emergency settings, as well as associated barriers and facilitators.

Authors' results and conclusions: RESULTS (#1 CHARACTERISTICS OF QUEBEC EMERGENCY DEPARTMENT USERS WITH MENTAL DISORDERS AND THEIR SERVICE USE): Analysis of Quebec clinical-administrative data by INESSS showed that, among all individuals aged 18 to 65 who visited a Quebec emergency department at least once in 2023-2024, 245,934, were diagnosed with a mental disorder. Among these users, compared with those who visited emergency departments only one or twice during the year, frequent users4: • experienced higher levels of social and material disadvantage; • were more likely to have had at least one visit for suicidal thoughts or behaviors; • had a higher number of chronic conditions affecting both mental and physical health. (#2 RELEVANT PRACTICES FOR ADDRESSING SERVICE USERS' NEEDS): This work also sought to identify practices that could better support individuals with mental disorders who frequently use emergency departments, while reducing visits that do not require the level of care provided in emergency settings. The practices identified as most relevant include: • strategies for redirecting individuals to primary care services; • care coordination; • interprofessional and interorganizational collaboration; • case management. CONCLUSION: In conclusion, this work demonstrated that individuals with mental disorders who use emergency departments frequently have urgent needs comparable to those who use these services less frequently. Moreover, they present more complex clinical profiles and a broader range of needs.

Authors' methods: The first evaluation question sought to describe the characteristics of individuals with mental disorders who frequently use the emergency department. To address this question, descriptive analyses were performed using 2023-2024 data from Quebec clinical-administrative databases, and a scoping review of Quebec scientific literature reporting clinical-administrative or epidemiological data was conducted. The second evaluation question sought to identify effective practices3 for addressing the needs of these individuals in emergency departments, as well as the associated barriers and facilitators. To answer this question, rapid reviews of the scientific and grey literature were conducted.

Project Status: Completed

Year Published: 2026

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/SoinsPremiereLigne/UFU_EP_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)