Suprakash Chaudhury, Partha Sarathi Biswas, Ajay Kumar Bakhla, Deepak Kumar Giri and Subodh Kumar Sinha
Background: Clinical screening of patients being presented for admission to a tertiary care psychiatric inpatients facility is important to ensure safe, timely, and effective treatment. Aim: To determine the demographic and clinical characteristics associated with admissible severe psychiatric patients and who required transfer to higher medical-surgical units; and to develop a system of care that bridges existing gaps between the mental and general health communities. Methods: Data of 1026 consecutive admissible severe psychiatric patients and two months follow up data of consecutive 930 admitted patients were documented. The data of 12 patients transferred within next two months of indoor treatment were evaluated to categorize the reasons for transfers. Results: Ninety six admissible patients (9.35%) before admission and twelve admitted patients (1.17%) during their hospital stay required transfer to a medical-surgical unit. Reasons for transfer before admission included lower respiratory tract infection (2.83%), anemia (2.24%), tuberculosis (1.56%), and cardiovascular diseases (1.36). Medical factors associated with rapid transfer out of the inpatient unit were chest pain, shortness of breath, electrolyte abnormalities, signs of infection, and changes in the level of consciousness. Conclusion: Inappropriate psychiatric admissions may be avoided by more vigilant screening for some physical diseases.