Emergency examination authorities in Queensland,Australia |
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| Authors: | Alan R Clough PhD Angela Evans MD PhD Veronica Graham PhD Janet Catterall MLIS Richard Lakeman PhD John Gilroy PhD Gregory Pratt BPsych Joe Petrucci MMHN Ulrich Orda PhD FACEM Rajesh Sehdev FACEM Neale Thornton FACEM Sourav Das PhD Gillian Yearsley MA Richard Stone FACEM |
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| Affiliation: | 1. College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia;2. Queensland Police Service, Far Northern Region, Cairns, Queensland, Australia;3. Library and Information Services, Division of Student Life, James Cook University, Cairns, Queensland, Australia;4. Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia;5. Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia;6. Aboriginal and Torres Strait Islander Health, The University of Sydney, Sydney, New South Wales, Australia;7. QLD and NT Neami National Cairns, Cairns, Queensland, Australia;8. Emergency Medicine, North West Hospital and Health Service, Mount Isa, Queensland, Australia;9. Emergency Medicine, Townsville Hospital and Health Service, Townsville, Queensland, Australia;10. Emergency Medicine, Mackay Hospital and Health Service, Mackay, Queensland, Australia;11. Statistics and Data Science, College of Science and Engineering, James Cook University, Cairns, Queensland, Australia;12. Northern Territory Primary Health Network, Darwin, Northern Territory, Australia;13. Emergency Medicine, Cairns Hospital, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia |
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| Abstract: | Objective In Queensland, where a person experiences a major disturbance in their mental capacity, and is at risk of serious harm to self and others, an emergency examination authority (EEA) authorises Queensland Police Service (QPS) and Queensland Ambulance Service (QAS) to detain and transport the person to an ED. In the ED, further detention for up to 12 h is authorised to allow the examination to be completed. Little published information describes these critical patient encounters. Methods Queensland's Public Health Act (2005), amended in 2017, mandates the use of the approved EEA form. Data were extracted from a convenience sample of 942 EEAs including: (i) patient age, sex, address; (ii) free text descriptions by QPS and QAS officers of the person's behaviour and any serious risk of harm requiring urgent care; (iii) time examination period commenced; and (iv) outcome upon examination. Results Of 942 EEA forms, 640 (68%) were retrieved at three ‘larger central’ hospitals and 302 (32%) at two ‘smaller regional’ hospitals in non-metropolitan Queensland. QPS initiated 342 (36%) and QAS 600 (64%) EEAs for 486 (52%) males, 453 (48%) females and two intersexes (<1%), aged from 9 to 85 years (median 29 years, 17% aged <18 years). EEAs commonly occurred on weekends (32%) and between 2300 and midnight (8%), characterised by ‘drug and/or alcohol issues’ (53%), ‘self-harm’ (40%), ‘patient aggression’ (25%) and multiple prior EEAs (23%). Although information was incomplete, most patients (78%, n = 419/534) required no inpatient admission. Conclusions EEAs furnish unique records for evaluating the impacts of Queensland's novel legislative reforms. |
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| Keywords: | emergency medical service involuntary hospitalisation involuntary treatment jurisprudence mental health |
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