Follow-Up After Emergency Department Visit for Mental Illness (FUM)

The percentage of emergency department (ED) visits for persons 6 years of age and older with a principal diagnosis of mental illness, or any diagnosis of intentional self-harm, and had a mental health follow-up service. Two rates are reported: 

  1. The percentage of ED visits for which the person received follow-up within 30 days of the ED visit (31 total days). 
  2. The percentage of ED visits for which the person received follow-up within 7 days of the ED visit (8 total days). 

Why It Matters

An estimated 1 in 5 adults live with a mental illness, which translates to about 57.8 million people (1). Recent research estimates that 1 in 6 children experience a mental health disorder each year (2). 

A substantial number of ED visits are related to mental health crises, including psychiatric emergencies, suicidal ideation, self-harm, and acute exacerbations of mental health disorders (3). Between 2017 and 2019, 52.9 of every 1,000 ED visits were due to mental illness (3). The ED serves as an initial point of contact for individuals experiencing a mental health crisis, especially when other resources such as outpatient mental health services, may not be readily accessible or available outside of regular office hours. 

Timely follow-up care is associated with remaining in the community for a longer period of time and avoidance of future emergency visits (4). Evidence suggests that patients who fail to receive aftercare following their emergency psychiatric visit have 6 times higher odds of returning to the ED within 2 months, compared with patients who received aftercare (5). Follow-up visits not only provide the opportunity for coordination of care, but also allow opportunities for providers to identify any changing or emerging issues, address treatment barriers, and intervene promptly. 

* Adapted from an NCQA measure with financial support from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) under Prime Contract No. HHSP23320100019WI/HHSP23337001T, in which NCQA was a subcontractor to Mathematica. Additional financial support was provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). 

Historical Results – National Averages

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References

  1. SAMHSA. 2022. Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health. HHS, PEP22-07-01–005(NSDUH Series H-57). https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
  2. Whitney, D.G., M.D. Peterson. 2019. “US National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children.” JAMA Pediatr 173(4):389–91. doi:10.1001/jamapediatrics.2018.5399
  3. Santo, L., J.Z. Peters, & J.C. DeFrances. 2021. “Emergency Department Visits Among Adults With Mental Health Disorders: United States, 2017–2019.” Centers for Disease Control and Prevention, NCHS Data Brief No. 426. https://www.cdc.gov/nchs/products/databriefs/db426.htm#Key_finding
  4. McCullumsmith, C., B. Clark, C. Blair, K. Cropsey, & R. Shelton. 2015. “Rapid Follow-Up for Patients After Psychiatric Crisis.” Community Mental Health Journal 51(2), 139–44. https://doi.org/10.1007/s10597-014-9782-z
  5. Bruffaerts, R., M. Sabbe, & K. Demyttenaere. 2005. “Predicting Aftercare in Psychiatric Emergencies.” Social Psychiatry and Psychiatric Epidemiology 40(10), 829–34. https://doi.org/10.1007/s00127-005-0959-x

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