Prolonged length of stay among individuals presenting to the emergency department with psychosis: Associations with sociodemographic and visit-level characteristics.

Introduction: Individuals experiencing psychosis commonly initiate and engage in treatment within an emergency department (ED) setting. Understanding factors contributing to adverse ED experiences is critical for improving psychosis-related treatment. Prolonged ED length of stay (LOS), which can be conversely associated with treatment quality, is not well explored among individuals experiencing psychosis.

Methods: In this retrospective analysis of 2129 ED visits for psychosis, we examined sociodemographic characteristics associated with prolonged ED LOS. Among these visits, which occurred from March 1, 2019-February 28, 2021, we also examined the risk of physical restraint, parenteral medication administration, disposition to inpatient psychiatric hospitalization, and substance use positivity by prolonged ED LOS status.

Results: Females, compared to males, were more likely to have prolonged ED LOS; no other sociodemographic characteristics were significantly associated with prolonged ED LOS. Visits with physical restraint, parenteral medication administration, and disposition to inpatient psychiatric hospitalization had a greater risk of prolonged ED LOS compared to visits without these factors.

Conclusions: These findings provide critical insight on approaches to reduce ED LOS among individuals experiencing psychosis and improve treatment engagement.