Management of Patients with Psychiatric Crises and Substance Addiction in an Emergency Department in Türkiye

Abstract Background: This retrospective observational study examines the effectiveness of new safety protocols that address psychiatric crises and substance abuse cases within emergency departments (EDs). Methods: The research examined 500 patient records spanning from 2020 to 2023 to evaluate treatment results between 278 patients who received new safety protocols and 222 patients who received standard care. The new protocols consisted of physical and pharmacological restraints together with enhanced security measures and psychiatric counseling. Descriptive and multivariate statistical analyses were conducted. The primary outcome was the patient discharge rate. The study measured secondary outcomes by evaluating ED stay duration, along with safety requirements, hospital admission, readmission frequencies, and treatment stability. Results: The discharge rate showed a substantial improvement in patients who received the protocol-based treatment, reaching 51% compared to 45% in patients without the protocol ( P < 0.05). The primary outcome measurement demonstrated improved results. The average duration of ED visit remained unchanged between groups (mean: 7.05 h, standard deviation: 3.42). Patients who were older in age and widowed needed fewer supplemental security interventions during their stay ( P < 0.05). The research showed that patients who graduated from university needed less hospitalization than other patients ( P = 0.034). Conclusion: The research shows that individualized safety protocols alongside interdisciplinary care can boost discharge rates for patients without extending their time in the ED. The research evidence supports implementing these protocols as standard emergency care procedures to improve both staff and patient safety and maximize resource effectiveness.