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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO394

Project +GP: Strengthening Right-Siting of Care for Patients with Acute Stress and Adjustment Disorders Discharged from a Psychiatric Emergency Service in Singapore

PROJECT +GP: ENHANCING RIGHT SITING FOR ACUTE STRESS AND ADJUSTMENT DISORDER PATIENTS DISCHARGED FROM A PSYCHIATRIC EMERGENCY SERVICE IN SINGAPORE

Three-quarters of patients with adjustment disorder and acute stress discharged from a psychiatric emergency service were managed through case manager follow-up alone, without requiring additional specialist or general practitioner assessment.

The aim was to evaluate the role of case managers in directing patients with adjustment disorder and acute stress reaction discharged from a psychiatric emergency service (ES) to the appropriate level of primary care (right-siting). The pilot established a structured workflow, standardizing eligibility criteria, a handover protocol for general practitioners (GPs), and proactive contact with patients by a case manager within two weeks of discharge. Service data from the first pilot year were examined using descriptive analysis. Of 164 eligible discharges, 125 (76.2%) were managed through case manager follow-up alone, without requiring additional specialist or GP assessment, while 39 patients (24%) were referred for medical assessment. Referrals for GP assessment accounted for 21%, and referrals for psychiatrist assessment accounted for 2.4%. Reasons for ending follow-up included self-reported recovery in 55.5% (56% in the figure), inability to contact the patient in 11.6% (12% in the figure), and alternative follow-up in 9.1%. Avoiding specialist outpatient and GP visits following case manager contact at two weeks was estimated to avert an average of US$600 in healthcare costs per patient; US$579 of this came from specialist outpatient costs covering physician services, investigations, rehabilitation, pharmacy services, support procedures, and overheads, and US$21 from the cost of a GP appointment. The authors attribute the high rates of declining follow-up both to genuine early recovery and to barriers to engagement. They suggest that early case manager-supported right-siting could transfer low-risk patients to community-based follow-up, freeing specialist capacity for more complex presentations.

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