LAUSR

Key Points Question What proportion of individuals aged 16 years and older seeking care at an emergency department (ED) for mental health or addiction-related reasons have had no access to outpatient services in the preceding 2 years? Findings In this cohort study, 659 084 adults had a first ED visit, among whom 298 924 (45.4%) had no prior outpatient contact. Characteristics associated with poor access to mental health care generally, such as male sex, living in a rural area, presenting with a substance use disorder, and no usual primary care clinician, were associated with a first ED visit for mental health or addiction-related reasons with no prior outpatient contact. Meaning Nearly half of incident psychiatric ED visits were first-contact visits, which may have been avoidable with better access to outpatient mental health and addiction services.