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Canadian Journal of Public Health

, Volume 107, Issue 3, pp e303–e311 | Cite as

Impact of a mass media mental health campaign on psychiatric emergency department visits

  • Joyce Cheng
  • Paul Benassi
  • Claire de Oliveira
  • Juveria Zaheer
  • Michael Collins
  • Paul Kurdyak
Public Health Intervention

Abstract

OBJECTIVE: Despite the high prevalence of mental illnesses and addictions, treatment rates remain low. In April 2010, a regional mass media campaign was implemented to increase awareness of mental health services in central Toronto, Canada. We studied the impact of this campaign on rates of psychiatric emergency department (PED) visits among all hospital emergency departments (EDs) located in Toronto.

DESIGN: Monthly PED visit totals were obtained for all Toronto EDs from April 1, 2007 to March 31, 2012 (n = 148,704). The campaign’s impact on visit rates was measured using interrupted time series analysis and a difference-in-difference estimator. We conducted pre- and post-campaign analyses to examine whether volume increases were explained by specific diagnostic categories and/or new presentations (new patients with no prior PED visits), and to examine geographic trends.

RESULTS: The campaign was associated with an increased volume of PED visits at downtown hospitals (Centre for Addiction and Mental Health, an increase of 7.6 visits/month [p < 0.0001]; University Health Network, 5.8 visits/month [p < 0.0001]; St. Michael’s Hospital, 4.2 visits/month [p < 0.0001]; and Mount Sinai Hospital, 3.2 visits/month [p < 0.0001]) but not in hospitals located outside of the downtown area. Neither new patient visits nor specific diagnostic categories disproportionately accounted for the overall observed increases. Following the campaign, patients travelled greater distances to receive ED services.

CONCLUSIONS: Mass media campaigns promoting mental health and psychiatric services can affect health care-seeking behaviour and utilization. Our findings have implications for system-level service planning, which should anticipate volume increases when public mental health campaigns are being considered.

Key Words

Health campaign psychiatry mental health addictions emergency services interrupted time series analysis 

Résumé

OBJECTIF : Malgré la prévalence élevée des maladies mentales et des toxicomanies, les taux de traitement demeurent faibles. En avril 2010, on a lancé une campagne régionale d’information dans les médias pour mieux faire connaître les services de santé mentale au centre-ville de Toronto, au Canada. Nous avons étudié l’impact de cette campagne sur les taux de visites aux services d’urgence en psychiatrie (SUP) dans l’ensemble des services d’urgence (SU) des hôpitaux de Toronto.

PLAN : Nous avons obtenu les totaux mensuels des visites aux SUP pour l’ensemble des SU de Toronto entre le 1er avril 2007 et le 31 mars 2012 (n = 148 704). Nous avons mesuré l’impact de la campagne sur les taux de visite à l’aide d’une analyse des séries chronologiques interrompues et d’un estimateur de la double différence. Nous avons mené des analyses pré- et post-campagne pour déterminer si les hausses de volume s’expliquaient par certaines catégories de diagnostic et/ou par de nouvelles présentations (de nouveaux patients n’ayant pas visité un SUP antérieurement) et pour examiner les tendances géographiques.

RÉSULTATS : La campagne a été associée à un volume accru de visites aux SUP dans les hôpitaux du centre-ville (Centre de toxicomanie et de santé mentale: hausse de 7,6 visites/mois [p < 0,0001]; Réseau médical universitaire: 5,8 visites/mois [p < 0,0001]; hôpital St. Michael’s: 4,2 visites/mois [p < 0,0001]; et hôpital Mount Sinai: 3,2 visites/mois [p < 0,0001]), mais pas dans les hôpitaux situés hors du centre-ville. Ni les visites de nouveaux patients, ni des catégories de diagnostic particulières n’ont expliqué de façon disproportionnée les hausses globales observées. Après la campagne, les patients ont parcouru de plus longues distances pour recevoir des services d’urgence.

CONCLUSIONS : Les campagnes d’information dans les médias faisant la promotion de la santé mentale et des services psychiatriques peuvent avoir un effet sur les comportements de recours aux soins de santé et sur l’utilisation des soins de santé. Nos constatations peuvent avoir des conséquences pour la planification systémique des services, car des hausses de volume sont à prévoir quand on envisage des campagnes de santé publique axées sur la santé mentale.

Mots Clés

campagne sanitaire psychiatrie santé mentale toxicomanie service urgences analyse des séries chronologiques interrompues 

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Copyright information

© The Canadian Public Health Association 2016

Authors and Affiliations

  • Joyce Cheng
    • 1
    • 2
  • Paul Benassi
    • 3
  • Claire de Oliveira
    • 4
    • 5
  • Juveria Zaheer
    • 6
  • Michael Collins
    • 7
  • Paul Kurdyak
    • 8
    • 9
    • 10
  1. 1.Institute for Mental Health Policy ResearchCentre for Addiction and Mental Health (CAMH)TorontoCanada
  2. 2.Institute for Clinical Evaluative Sciences (ICES)TorontoCanada
  3. 3.Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.Independent Scientist and Health Economist, Institute for Mental Health Policy ResearchCAMHTorontoCanada
  5. 5.Institute for Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  6. 6.CAMHTorontoCanada
  7. 7.Toronto WaterTorontoCanada
  8. 8.Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy ResearchCAMHTorontoCanada
  9. 9.Mental Health and Addictions Research ProgramICESTorontoCanada
  10. 10.Department of Psychiatry, Faculty of Medicine, and IHPME, Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

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