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

  • Public Health Intervention
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

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.

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.

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Author information

Authors and Affiliations

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, Canada, M5S 2S1

    Joyce Cheng MSc (Research Coordinator, Appointed Analyst)

  2. Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada

    Joyce Cheng MSc (Research Coordinator, Appointed Analyst)

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Paul Benassi MD (Resident)

  4. Independent Scientist and Health Economist, Institute for Mental Health Policy Research, CAMH, Toronto, ON, Canada

    Claire de Oliveira PhD (Independent Scientist and Health Economist, Assistant Professor)

  5. Institute for Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Claire de Oliveira PhD (Independent Scientist and Health Economist, Assistant Professor)

  6. CAMH, Toronto, ON, Canada

    Juveria Zaheer MD (Psychiatrist and Research Fellow)

  7. Toronto Water, Toronto, ON, Canada

    Michael Collins PEng (Engineer)

  8. Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, CAMH, Toronto, ON, Canada

    Paul Kurdyak MD, PhD (Director, Core Senior Scientist and Lead, Associate Professor)

  9. Mental Health and Addictions Research Program, ICES, Toronto, ON, Canada

    Paul Kurdyak MD, PhD (Director, Core Senior Scientist and Lead, Associate Professor)

  10. Department of Psychiatry, Faculty of Medicine, and IHPME, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Paul Kurdyak MD, PhD (Director, Core Senior Scientist and Lead, Associate Professor)

Authors
  1. Joyce Cheng MSc
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  2. Paul Benassi MD
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  3. Claire de Oliveira PhD
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  4. Juveria Zaheer MD
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  5. Michael Collins PEng
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  6. Paul Kurdyak MD, PhD
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Corresponding author

Correspondence to Joyce Cheng MSc.

Additional information

Acknowledgements: This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent of the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI.

Conflict of Interest: None to declare.

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Cheng, J., Benassi, P., de Oliveira, C. et al. Impact of a mass media mental health campaign on psychiatric emergency department visits. Can J Public Health 107, e303–e311 (2016). https://doi.org/10.17269/CJPH.107.5265

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  • DOI: https://doi.org/10.17269/CJPH.107.5265

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