Photo Credit: courtneyk

The following is a summary of “Nationwide study of emergency care quality for patients with substance use disorders and dual diagnoses across three distinct patient populations,” published in the March 2025 issue of BMC Psychiatry by Mackenhauer et al. 

Substance use and mental illness raise risks of morbidity and mortality. Dual diagnoses further worsen health outcomes. 

Researchers conducted a retrospective study to assess emergency medical services (EMS) and emergency care quality for two time-sensitive conditions in patients with mental illness, substance use disorders, and dual diagnoses. 

They analyzed data from three Danish registries: Prehospital (2016–2017), Stroke (2010–2018), and Emergency Surgery (2008–2018), using predefined clinical metrics. Exposure groups included patients with mental illness, substance use disorders, and dual diagnoses, compared with a reference group. 

The results showed 492,388 EMS calls, 89,148 ischemic strokes, and 3,223 emergency ulcer surgeries. Mental illness, substance use, and dual diagnoses were most common in patients receiving EMS (10%, 9%, 8%). Compared to reference, patients receiving EMS had higher repeat calls within 24 h (RR 1.60, 2.32, 3.24) and more unplanned visits after scene release (RR 1.50, 1.58, 2.50). Patients with stroke were less likely to get reperfusion (RR 0.80, 0.60, 0.69) but had similar care otherwise. Patients with perforated ulcer and mental illness had 82 min surgical delay. Median days alive-and-out-of-hospital were reduced by 4, 6, and 7 days in the 3 groups. 

Investigators identified disparities in EMS response, reperfusion therapy, and surgical timeliness among patients with mental illness, substance use, and dual diagnoses. They also observed consistent quality in guideline-based stroke care. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06712-8