Social Work in Emergency Departments: A Multi-Dimensional Analysis of Social Determinants, Interventions, and Outcomes

Social Work in Emergency Departments: A Multi-Dimensional Analysis of Social Determinants, Interventions, and Outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Social Work in Emergency Departments: A Multi-Dimensional Analysis of Social Determinants, Interventions, and Outcomes Melih Çamcı, Şeyma Yüsra Soğanda, Muhammed Fatih Baran, Muhammed Şafi Alpaslan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6371088/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This retrospective cohort study investigates the role and impact of social work interventions in the emergency department (ED) of a high-capacity urban tertiary hospital in Türkiye. The study analyzes data from 714 adult patients referred to the hospital's social work unit between 2019 and 2024. The findings reveal that social workers play a critical role in addressing psychosocial issues, particularly among vulnerable populations such as individuals experiencing homelessness, victims of violence, and disaster survivors. Common diagnoses included lack of family support, physical disorders, and trauma-related conditions. The most frequent interventions involved psychosocial support, facilitation of housing and transportation, and communication with relatives. A statistically significant difference was observed between daytime and nighttime consultations, with fewer patients interviewed and assessed effectively during off-hours, underscoring the need for 24/7 social work coverage. Additionally, survivors of the 2023 Türkiye earthquakes showed high rates of unmet psychosocial needs, highlighting the role of ED social work in disaster response. The study concludes that the integration of social workers into emergency care settings enhances patient outcomes, improves care continuity, and optimizes healthcare resource utilization. It recommends policy measures to ensure continuous social work availability in EDs. Humanities/Health humanities Humanities/Medical humanities Emergency departments Social work Health services Vulnerable populations Social determinants of health Crisis intervention Hospital resource utilization Figures Figure 1 Introduction Emergency departments (EDs) are critical healthcare providers for individuals experiencing acute medical conditions and trauma (Moore et al., 2012 ). Currently, emergency departments (EDs) have become primary points of contact for patients facing social determinants of health, including homelessness, poverty, substance abuse, domestic violence, and mental health disorders (Marks et al., 2020 ; van Tiel et al., 2015 ). Social determinants of health (SDoH) encompass the environmental conditions in which individuals are born, live, receive education, work, and experience aging, directly influencing functionality, health, and quality of life. These factors include poverty, discrimination, exposure to violence, food and housing insecurity, and inadequate health literacy (Walter et al., 2021 ). SDoH contributes to disparities in healthcare access, resulting in poorer health outcomes (Bywaters & McLeod, 2003 ; Walter et al., 2021 ). EDs function as essential safety nets within the healthcare system, serving as a primary access point, particularly for individuals with limited access to medical services (Selby et al., 2018 ). In this context, the provision of social work services in EDs is crucial for mitigating the impact of social determinants of health on the healthcare system and promoting holistic patient care. The presence of social workers in EDs is essential for improving patient care and optimizing healthcare services (Moore et al., 2012 ). Social workers play a essential role in conducting psychosocial assessments, providing crisis intervention, coordinating case management, and referring patients to appropriate community resources (American College of Emergency Physicians, 2011 ; Kamrujjaman et al., 2023 ). These services also encompass addressing significant psychosocial issues such as alcohol and substance abuse, domestic violence, and neglect (Marks, J. et al., 2020 ; Allen, Danielle et al., 2024). Moreover, social workers play an pivotal role in providing culturally competent care by advocating for patients' cultural values and acting as intermediaries (Selby, Sasha et al., 2018). However, in many healthcare systems, social workers have not been fully integrated, leading to inefficient utilization of hospital resources (Çalgı, Berna et al., 2020; Moore, Megan et al., 2017). The effectiveness of social work interventions in EDs has been demonstrated in numerous studies. Auerbach and Mason ( 2010 ) found that these interventions can reduce unnecessary hospital admissions. Similarly, the American College of Emergency Physicians ( 2011 ) emphasized that social work services are a vital component of the ED, forming an essential part of the healthcare safety net and supporting a broad patient population. Furthermore, Gordon ( 2001 ) demonstrated the cost-effectiveness of social work interventions through improved hospital resource utilization and overall healthcare cost reduction. However, most existing studies offer only short-term analyses, lacking the comprehensive, long-term evaluations necessary to fully understand the impact of these interventions. To address this gap, a thorough assessment of patients’ sociodemographic profiles, reasons for ED visits, diagnoses, social work interventions, and discharge outcomes is warranted in the literature. The role of social workers in EDs is multifaceted and tailored to the individual needs of patients and their families. Social workers collaborate with physicians, nurses, and other healthcare professionals to address the psychosocial needs of patients in the emergency setting (American College of Emergency Physicians [ACEP], 2011; Moore et al., 2017 ). As part of this interdisciplinary approach, social workers provide emotional support, refer patients to substance abuse treatment resources, assist victims of domestic violence, and facilitate access to essential services such as housing and transportation (Tom et al., 2023 ; Yıldırım & Başer, 2019 ). Furthermore, ensuring continuity of care following ED discharge is also a core responsibility of social workers (ACEP, 2011). This study provides a comprehensive and multidimensional analysis of the impact of social work interventions in emergency departments on patient outcomes and the healthcare system. As part of a six-year retrospective analysis, this study examines the impact of social work interventions in EDs on patient care and outcomes, healthcare services, and ED utilization. Additionally, this study explores the challenges and opportunities associated with the integration of social work in EDs and provides recommendations to strengthen the role of social work services in improving patient care and enhancing the efficiency of healthcare delivery. Methods This retrospective cohort study included patients over the age of 18 who presented to the Emergency Medicine Department of a high-capacity tertiary hospital in Türkiye between February 2019 and February 2024, were referred to the social work unit, and underwent a social assessment. Records with missing or insufficient data, as well as repeated consultations for the same patient, were excluded. The study aimed to evaluate the impact of social work interventions on patient outcomes. Variables analyzed included demographic and clinical characteristics, time and reason for admission, social work interventions, diagnoses, and discharge outcomes. Data were retrospectively collected from institutional electronic health records, social work assessment forms, and patient monitoring systems. Ethical approval was obtained from the appropriate institutional review board, and all research procedures were conducted in accordance with the Declaration of Helsinki. Due to the retrospective and anonymized nature of the study, informed consent was waived by the ethics committee. Independent variables included age, gender, social security status, marital status, educational level, time of emergency department admission (year, month, day, hour), admission unit, type of admission, and consultation request timing. Dependent variables included the type of social work intervention (e.g., psychosocial support, referral to services, crisis intervention), patient outcomes (e.g., discharge, hospitalization, death, unauthorized discharge), diagnosis, reason for consultation, social work unit assessment, and patient outcome of ED. Data analysis was performed using SPSS version 22.0. Descriptive statistics were reported as frequency, percentage, mean, and standard deviation. The chi-square test was used to compare categorical variables, and a p-value < 0.05 was considered statistically significant. Results A total of the 714 patients included in the study, 48.0% (n=343) were male and the median age was 56 (IQR:37-72). The majority of patients (98.0%) were covered by the Social Security Institution (SGK). Most admissions occurred between 2023 (39.6%) and 2022 (20.2%). The most frequent month of admission was February (16.4%), and admissions were most commonly made between 00:00 and 12:00 (37.4%). A large proportion of patients (86.0%) were managed in the yellow zone, and 94.3% were evaluated on an outpatient basis. The median duration between admission and consultation was 1 day (IQR: 0–1). Detailed sociodemographic and clinical characteristics are summarized in Table 1. The most common diagnosis was lack of family support and homelessness (35.0%), followed by physical disorders (28.7%) and assault (20.0%). The leading reasons for consultation were guidance (28.0%) and housing needs (24.9%). Psychosocial counseling was provided in 40.8% of cases, while in 32.8% of consultations, social workers facilitated access to needs and transportation. The majority of patients (88.2%) were discharged from the emergency department. Detailed findings are presented in Table 2. Among patients consulted between 18:00 and 06:00, the most prevalent social work unit assessment outcome was 'not interviewed,' suggesting a greater likelihood of incomplete psychosocial evaluations during nighttime consultation hours. Among patients consulted between 06:00 and 18:00, the most prevalent social work unit assessment outcome was “needs met,” indicating that daytime consultations were more likely to result in effective service delivery by the social work unit (p < 0.001) (Table 3). Among patients consulted between 18:00 and 06:00, the highest diagnostic rate was observed in cases of sexual abuse. Among patients consulted between 06:00 and 18:00, the highest diagnostic rate was identified in those diagnosed with physical disorders (p < 0.001) (Table 3). A total of 589 patients were included in the analysis after excluding individuals who could not be interviewed, left the hospital without permission, or refused treatment, as indicated by the social work unit outcomes. Among those categorized as having received "information," consultations were most frequently associated with cases of sexual abuse and violence. In contrast, patients whose needs were met or who were admitted to the hospital were predominantly earthquake survivors (p < 0.001) (Table 4). Patients in the "information provided" group most commonly left the hospital without permission, whereas those in the "needs met/inpatient admission" category were primarily hospitalized as their ED outcome (p < 0.001). Regarding diagnostic patterns, the highest rates of sexual abuse were observed among patients who only received information, while physical disorders were most prevalent among those whose needs were met or who were admitted for inpatient care (p < 0.001) (Table 4). Table 5 summarizes the social work assessments of patients consulted for sexual abuse and violence (n=79) and alcohol and substance use (n=19). Psychosocial interviews were the most common intervention in both groups. No statistically significant difference was observed between the groups (p > 0.05). A total of 644 patients were included in the analysis after excluding those who could not be interviewed based on the social work unit assessments. Among non-earthquake survivors, the most prevalent social work unit assessment outcome was contact with relatives. In contrast, among earthquake survivors, the most frequent assessment outcome was psychosocial interview (p < 0.001) (Figure 1). Discussion This study highlights the critical role of social work services in EDs in influencing both patient outcomes and the healthcare system. The findings emphasize the complex and multifaceted nature of social work practice within EDs and reveal key areas where the development of interventions is needed. The characteristics of 714 patients who required social work support in the ED of a high-volume city hospital were examined, along with the services delivered to them. The fact that 52% of the included cases were female and 48% were male suggests that women may have a greater need for social work services. This finding aligns with previous research indicating that women are more frequently represented among frequent users of EDs (van Tiel et al., 2015 ). The median age of 56 (range: 37–72) suggests that individuals in middle and older age groups may particularly require social work interventions in emergency settings. Similarly, Yalçınlı et al. (2021) reported a comparable mean age of 55.6 ± 20.3 in their study. These results underscore the importance of developing targeted social work intervention strategies for older adults in emergency departments. Although 98% of the patients were covered by the Social Security Institution, the continued need for social work services suggests that insurance coverage alone is insufficient to address the complex social problems encountered in EDs. This finding reflects the multidimensional nature of social issues observed in emergency care settings. The year-by-year distribution of admissions reveals a clear upward trend, which may be attributed to external factors such as the COVID-19 pandemic and natural disasters (earthquake etc.), as well as internal dynamics like changes in hospital policies. Yıldırım and Başer ( 2019 ) emphasized the importance of understanding how patient profiles and social work needs evolve over time. Regarding the distribution of admissions by month, a significant concentration was observed in February, likely associated with the earthquakes that struck southeastern Türkiye, centered in Kahramanmaraş, on February 6, 2023. The hourly distribution of patient visits indicates that social work needs persist throughout the day. However, the concentration of consultation requests during regular working hours suggests that the absence of social work services during off-hours may contribute to prolonged waiting times in the ED. Following physical pathologies, traumatic events such as physical assault, suicide attempts, and sexual abuse represent significant challenges encountered in EDs. Social workers play a key role in the follow-up of these cases and in directing patients to appropriate services (Marks et al., 2020 ; Allen et al., 2024 ). In their study, Yalçınlı et al. (2021) identified the most common reasons for social work consultations as housing (36.2%), transportation (30.0%), and guidance (18.9%). While housing and guidance needs aligned with existing literature, a notable proportion of consultations were also related to violence, sexual abuse, and forensic cases. These findings highlight the necessity of integrating social workers into healthcare systems and emphasize their role in improving patients’ access to psychosocial support. The prominence of social determinants such as inadequate family support and homelessness further reinforces the role of EDs as essential safety nets for public health (Selby et al., 2018 ; Moore et al., 2017 ). Common social work interventions included psychosocial support (40.8%), contacting family members (25.1%), and addressing basic needs (24.4%). As Tom et al. ( 2023 ) note, social workers play a key role in helping patients and their families navigate emergency care more effectively. Additionally, Gordon ( 2001 ) demonstrated the cost-effectiveness of these services, and the model proposed by Bywaters and McLeod ( 2003 ) offers a valuable framework for understanding their impact on emergency department utilization. The hourly distribution and outcomes of social work consultations originating from EDs highlight the clear need for 24/7 social work coverage. The majority of consultations (80.6%) occurred between 06:00 and 18:00. Among patients consulted between 18:00 and 06:00, the highest rate of social work unit assessment was recorded in cases where patients could not be interviewed (37.1%). This suggests that various factors may hinder access to social workers during nighttime hours. Conversely, during the 06:00–18:00 interval, the highest assessment rates were observed among patients whose needs were met (86.2%) and those for whom contact with relatives was established (84.4%). This may indicate that social workers are more able to address needs such as housing, transportation, and financial assistance during daytime hours. As emphasized by Moore et al. ( 2017 ), high patient volume and time constraints in EDs can significantly increase the workload of social workers. Therefore, it is essential to ensure adequate institutional support and create appropriate working conditions for social work professionals. Social work interventions in emergency departments must be tailored to meet the specific needs of patients. As noted by Tom et al. ( 2023 ), social workers should implement a variety of interventions to help patients and their families navigate the ED experience more effectively. The high prevalence of sexual abuse and violence cases among patients who received only informational support is noteworthy. In their study, Marks et al. ( 2020 ) examined how domestic violence is addressed through social work interventions in EDs, emphasizing that early involvement of social workers in honor-based violence (HBV) cases is crucial for the protection and support of victims. Similarly, studies focusing on pediatric emergency patients have highlighted the pivotal role of social workers in identifying and intervening in cases of child abuse and neglect (Bardak et al., 2021). The notable presence of earthquake survivors among patients whose needs were met further illustrates the important role EDs play in disaster response through the provision of social services. Walter et al. ( 2021 ) emphasized how EDs serve as public health safety nets and the vital role social workers play in meeting the needs of disaster-affected individuals. These findings underscore the essential function of social work in disaster preparedness and response. Among patients who were admitted to inpatient care, psychiatric disorders were frequently observed. This finding reinforces the importance of comprehensive psychosocial assessment and appropriate referral in EDs for individuals presenting with mental health issues. Prior research has highlighted the need to develop early intervention strategies aimed at reducing ED visits among individuals with psychiatric conditions, and that social workers can play a significant role in this process (van Tiel et al., 2015 ; Gabet et al., 2023 ; Cassarino et al., 2019 ). Among those referred to institutional care, inadequate family support and homelessness were particularly prominent, suggesting that EDs must address not only medical but also complex social needs. Additionally, the fact that most patients discharged to their families had been referred due to physical conditions indicates the necessity of supporting and informing caregivers as part of the care process. Among victims of sexual abuse and violence, as well as individuals presenting to the ED due to alcohol and substance use, psychosocial interviews emerged as the most common outcome in social work assessments. This underscores the importance of enhancing ED staff’s ability to identify and appropriately respond to such cases. As highlighted by Allen et al. ( 2024 ), emergency personnel require specialized training to effectively support victims of domestic violence. Similarly, Gabet et al. ( 2023 ) emphasized the need for further research on the effectiveness of emergency department interventions targeting individuals with substance use disorders. Ensuring timely referral of these patients to addiction treatment and rehabilitation services is essential. Furthermore, collaboration between EDs, other healthcare providers, and social service institutions must be strengthened to provide coordinated and comprehensive care (Kamrujjaman et al., 2023 ; Selby et al., 2018 ). Another notable finding is the high demand for social work interventions among earthquake survivors. It was determined that 96.7% of these patients had their needs addressed through either inpatient hospitalization or referral to supportive services. Psychosocial support emerged as the most commonly identified need among this group. In the aftermath of disasters, psychosocial support and rehabilitation processes are of critical importance. In this context, the findings highlight the necessity of expanding and systematizing crisis intervention protocols within EDs (Kamrujjaman et al., 2023 ; Saruç, 2015 ). Given the limited literature on social work interventions for disaster-affected populations, the results of this study offer valuable contributions to understanding the social dimension of post-disaster healthcare delivery. Social work practices in EDs support patients’ healthcare journeys in a more holistic manner by not only providing housing assistance, psychosocial support, and guidance services, but also assuming critical roles in crisis intervention, access to resources, and counseling. The retrospective design of this study limits the ability to draw causal inferences. Additionally, the data were collected from a single center, which restricts the generalizability of the findings to other institutions or regions. Furthermore, the absence of certain key data—such as missing consultation request reasons in some records—should also be considered a limitation of the study. This study highlights the central role of social workers in the delivery of healthcare services within EDs. The findings demonstrate that social work not only enhances individual patient care, but also contributes to the overall efficiency of the healthcare system. For individuals experiencing homelessness, those lacking adequate family support, and patients in need of crisis intervention, the presence of social workers should be considered an essential component of multidisciplinary healthcare. Strengthening social work services in EDs offers not only improved quality of care, but also strategic advantages in terms of resource management and cost-effectiveness for hospitals. Future research should comprehensively examine the long-term impacts of social work interventions on patient health outcomes and develop new models to optimize the integration of social workers into EDs. Health policies should aim to expand the role of social workers and promote broader access to these essential services. Ultimately, the integration of social work and medical care will strengthen the role of EDs as a public health safety net and contribute to the advancement of patient care standards. Declarations Author Contribution M.Ç. conceptualized and designed the study, supervised data collection, and drafted the main manuscript text. Ş.Y.S. contributed to literature review, interpretation of findings, and manuscript editing. M.F.B. conducted the statistical analyses and contributed to the methodology section. M.Ş.A. supported data extraction and assisted in table and figure preparation. All authors reviewed and approved the final manuscript. Data availability The datasets generated and/or analysed during the current study are not publicly available due to institutional restrictions and participant confidentiality but are available from the corresponding author on reasonable request. References Bywaters, P., & McLeod, E. (2003). Social care's impact on emergency medicine: a model to test. Emerg Med J , 20 (2), 134-137. https://doi.org/10.1136/emj.20.2.134 Marks, J., Markwell, A., Randell, T., & Hughes, J. (2020). Domestic and family violence, non-lethal strangulation and social work intervention in the emergency department. Emerg Med Australas , 32 (4), 676-678. https://doi.org/10.1111/1742-6723.13519 Moore, M., Ekman, E., & Shumway, M. (2012). Understanding the critical role of social work in safety net medical settings: framework for research and practice in the emergency department. Soc Work Health Care , 51 (2), 140-148. https://doi.org/10.1080/00981389.2011.610872 Selby, S., Wang, D., Murray, E., & Lang, E. (2018). Emergency Departments as the Health Safety Nets of Society: A Descriptive and Multicenter Analysis of Social Worker Support in the Emergency Room. Cureus . https://doi.org/10.7759/cureus.3247 van Tiel, S., Rood, P. P., Bertoli-Avella, A. M., Erasmus, V., Haagsma, J., van Beeck, E., Patka, P., & Polinder, S. (2015). Systematic review of frequent users of emergency departments in non-US hospitals: state of the art. Eur J Emerg Med , 22 (5), 306-315. https://doi.org/10.1097/mej.0000000000000242 Walter, L. A., Schoenfeld, E. M., Smith, C. H., Shufflebarger, E., Khoury, C., Baldwin, K., Hess, J., Heimann, M., Crosby, C., Sontheimer, S. Y., Gragg, S., Hand, D., Mcilwain, J., American College of Emergency Physicians. (2011). Social work and case management in the emergency department [White paper]. https://www.acep.org/siteassets/new-pdfs/preps/social-work-and-case-management-in-the-emergency-department.pdf Kamrujjaman, M., Demetriou, C., Cuartas Álvarez, T., & Castro Delgado, R. (2023). The Role of Social Work for Emergency Medical Services (EMS): A Systematic Review. Prehospital and Disaster Medicine , 38 (5), 628-635. https://doi.org/10.1017/s1049023x23006143 Allen, D., Shaw, K., Mcdonald, P., Schmidt, D., Duncanson, K., & Allan, J. (2024). Enabling Emergency Department Staff to Support Domestic Violence Victims of Strangulation. Australian Social Work , 1-15. https://doi.org/10.1080/0312407x.2024.2399562 Çalgı, B., Yavuz Erdal, B. r., Çakın, E., Dogan, S., & Özüçelik, D. a. N. (2020). Hastanede Sosyal Hizmet Uzmanı ve Tıbbi Sosyal Hizmet Farkındalığının Değerlendirilmes. Journal of ADEM , 1(3), 23-38. Auerbach, C., & Mason, S. E. (2010). The value of the presence of social work in emergency departments. Soc Work Health Care , 49 (4), 314-326. https://doi.org/10.1080/00981380903426772 Gordon, J. A. (2001). Cost‐Benefit Analysis of Social Work Services in the Emergency Department: A Conceptual Model. Academic Emergency Medicine , 8 (1), 54-60. https://doi.org/10.1111/j.1553-2712.2001.tb00552.x Tom, J., Thomas, E. K., Sooraj, A., Uthaman, S. P., Tharayil, H. M., S, L. A., & Radhakrishnan, C. (2023). Need for social work interventions in the emergency department. Soc Work Health Care , 62 (8-9), 302-319. https://doi.org/10.1080/00981389.2023.2238017 Yıldırım, B. r., & Başer, A. O. (2019). Acil Servis Tıbbi Sosyal Hizmet Müdahaleleri, Müracaatçı Profili Ve Sosyal Hizmet Mülakatında Dikkat Edilmesi Gereken Durumlar [Emergency Service Medical Social Work Interventions, Client Profile and The Points to Take Into Consideration in Social Work Interview]. Toplum ve Sosyal Hizmet , 30 (1), 286-308. https://doi.org/10.33417/tsh.516859 van Tiel, S., Rood, P. P., Bertoli-Avella, A. M., Erasmus, V., Haagsma, J., van Beeck, E.,…Polinder, S. (2015). Systematic review of frequent users of emergency departments in non-US hospitals: state of the art. Eur J Emerg Med , 22 (5), 306-315. https://doi.org/10.1097/mej.0000000000000242 Yalçinli, S., Karbek Akarca, F., & Yerdelen, B. (2021). Acil serviste tıbbi sosyal hizmet müdahalesi gereksinimi olan hastaların retrospektif değerlendirilmesi. Ege Tıp Dergisi , 60 (4), 402-406. https://doi.org/10.19161/etd.1037758 Moore, M., Cristofalo, M., Dotolo, D., Torres, N., Lahdya, A., Ho, L.,…Fouts, S. (2017). When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services. Social Science & Medicine , 178 , 104-114. https://doi.org/10.1016/j.socscimed.2017.02.014 Walter, L. A., Schoenfeld, E. M., Smith, C. H., Shufflebarger, E., Khoury, C., Baldwin, K.,…Hess, E. P. (2021). Emergency department–based interventions affecting social determinants of health in the United States: A scoping review. Academic Emergency Medicine , 28 (6), 666-674. https://doi.org/10.1111/acem.14201 Gabet, M., Armoon, B., Meng, X., & Fleury, M.-J. (2023). Effectiveness of emergency department based interventions for frequent users with mental health issues: A systematic review. The American Journal of Emergency Medicine , 74 , 1-8. https://doi.org/10.1016/j.ajem.2023.09.008 Cassarino, M., Robinson, K., Quinn, R., Naddy, B., O’Regan, A., Ryan, D.,…Galvin, R. (2019). Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review. Plos One , 14 (7), e0220709. https://doi.org/10.1371/journal.pone.0220709 Saruç, S. (2015). A General Evaluation about the Medical Social Work in Turkey. Turkish Journal of Family Medicine and Primary Care , 9 (3), 112-120. Tables Table 1. Sociodemographic Characteristics and Emergency Department Admission Details % n Gender Male Female 48.0 52.0 343 371 Age Median (25th-75th percentile) 56 (37-72) Social Security Status SGK (Social Security Institution) Contracted Self-Pay 98.0 1.0 1.0 700 7 7 Year of Admission 2019 2020 2021 2022 2023 2024 4.5 9.2 13.7 20.2 39.6 12.7 32 66 98 144 283 91 Month of Admission January February March April May June July August September October November December 6.7 16.4 6.6 5.9 6.9 10.2 7.7 9.0 6.0 9.2 9.0 6.4 48 117 47 42 49 73 55 64 43 66 64 46 Time Interval of Admission 00:00-12:00 12:00-18:00 18:00-24:00 37.4 35.3 27.3 267 252 195 Admission Unit Yellow Zone Red Zone 86.0 14.0 614 100 Type of Admission Emergency Examination Hospitalization 94.3 5.7 673 41 Time Interval of Consultation Request 00:00-06:00 06:00-12:00 12:00-18:00 18:00-24:00 10.6 47.9 32.6 8.8 76 342 233 63 Number of Days Between Admission and Consultation Median (25th-75th percentile) 1 (0-1) Total 100 714 % : frequency, 25th-75th percentile : first and third quartiles Table 2. Diagnoses (ICD Codes), Reasons for Consultation, Social Work Unit Assessments, Consultation and Patient Outcomes in the Emergency Department % n Diagnosis Assault Psychiatric disorder Physical disorder Sexual abuse Suicide attempt Lack of family support and homelessness 20.0 5.2 28.7 2.7 8.4 35.0 143 37 205 19 60 250 Reason for Consultation Forensic case Housing need Alcohol and substance use Sexual abuse and violence Earthquake survivor Suicide attempt Guidance Communication issue Other 8.3 24.9 2.7 11.1 4.5 5.7 28.0 9.0 5.9 59 178 19 79 32 41 200 64 42 Social Work Unit Assessment Needs met Not interviewed Psychosocial counseling Contacted relatives 24.4 9.8 40.8 25.1 174 70 291 179 Consultation Outcome Provided information Facilitated access to needs and transportation Not interviewed Hospital admission Treatment refusal 43.6 32.8 14.3 6.2 3.2 311 234 102 44 23 Patient Outcome of Emergency Department Death Hospital admission Unauthorized discharge Discharged 0.7 7.0 4.1 88.2 5 50 29 630 Total 100 714 % : Frequency Table 3. Distribution of Social Work Unit Assessments and Patient Admission Diagnoses According to Consultation Time Social Work Unit Assessment 18:00–06:00 06:00–18:00 p* Needs met 13.8% (n=24) 86.2% (n=150) <0.001 Not interviewed 37.1% (n=26) 62.9% (n=44) Psychosocial interview 21.0% (n=61) 79.0% (n=230) Contact with relatives 15.6% (n=28) 84.4% (n=151) Patient Admission Diagnosis Physical assault 31.5% (n=45) 68.5% (n=98) <0.001 Psychiatric disorder 21.6% (n=8) 78.4% (n=29) Physical disorder 13.2% (n=27) 86.8% (n=178) Sexual abuse 42.1% (n=8) 57.9% (n=11) Suicide attempt 21.7% (n=13) 78.3% (n=47) Lack of family support and homelessness 15.2% (n=38) 84.8% (n=212) Total 19.4% (n=139) 80.6% (n=575) *p-value based on Chi-square test. Table 4. Evaluation of Consultation Reasons, Emergency Department Outcomes, and Admission Diagnoses According to Social Work Unit Outcomes Consultation Reason Provided Information Needs Met & In-Hospital Admission p* Forensic case 70.8 % (n=34) 29.2% (n=14) <0.001 Housing need 70.7% (n=106) 29.3% (n=44) Alcohol and substance use 60.0% (n=6) 40.0% (n=4) Sexual abuse and violence 75.4% (n=49) 24.6% (n=16) Earthquake survivor 3.3% (n=1) 96.7% (n=29) Suicide attempt 71.4% (n=15) 28.6% (n=6) Guidance 36.9% (n=62) 63.1% (n=106) Communication 31.6% (n=18) 68.4% (n=39) Other 50.0% (n=20) 50.0% (n=20) Patient Outcome of Emergency Department Death 40.0% (n=2) 60.0% (n=3) <0.001 Hospital admission 2.2% (n=1) 97.8% (n=44) Unauthorized discharge 66.7% (n=4) 33.3% (n=2) Discharged 57.0% (n=304) 43.0% (n=229) Patient Admission Diagnosis Physical assault 65.5% (n=78) 65.5% (n=78) <0.001 Psychiatric disorder 39.3% (n=11) 60.7% (n=17) Physical disorder 38.9% (n=70) 61.1 % (n=110) Sexual abuse 83.3% (n=15) 16.7% (n=3) Suicide attempt 60.6% (n=20) 39.4% (n=13) Lack of family support and homelessness 55.5% (n=117) 44.5% (n=94) Total 52.9% (n=311) 47.1% (n=278) *p-value based on Chi-square test. Table 5. Social Work Unit Assessments of Patients Consulted Due to Sexual Abuse and Violence, and Alcohol and Substance Use* Social Work Unit Assessment Sexual Abuse and Violence Alcohol and Substance Use Needs met 22.8% (n=18) 15.8% (n=3) Not interviewed 11.4% (n=9) 26.3% (n=5) Psychosocial interview 54.4% (n=43) 47.4% (n=9) Contact with relatives 11.4% (n=9) 10.5% (n=2) *p-value calculated using the Chi-square test. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6371088","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":501458689,"identity":"122dc1d9-7fc9-4f91-8425-1d210be44bb7","order_by":0,"name":"Melih Çamcı","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7ElEQVRIiWNgGAWjYFAC5obDEJr5AANjA4iVQEgLI0wLWwJCywECWpghDB4D4rTotjc2Hi6osYvmb+f5+Jl3x2EGfvYcA+aPe3BrMTtzsOHwjGPJuTMO826W5j1zmEGy540Bw4FneLTcSGw4zNvAnLuBmXeDNG/bYQaDGzlALXhcZnb/IUhLPVALz+PfIC32BLXcYARpOQzSwgaxRYKQljNAh/EcOw70C5uZ5dwz6TwSZ54VHDiDT8vxw4c/89RU5/b3H3584+0Oazn+9uSNDyrwaEEBTDzA2AExiNUAjNUfRCsdBaNgFIyCkQQApAFaoLVoBtUAAAAASUVORK5CYII=","orcid":"","institution":"Ankara Yıldırım Beyazıt University","correspondingAuthor":true,"prefix":"","firstName":"Melih","middleName":"","lastName":"Çamcı","suffix":""},{"id":501458690,"identity":"9afbe4b3-1b03-435c-bded-8986aa1bf2a3","order_by":1,"name":"Şeyma Yüsra Soğanda","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Şeyma","middleName":"Yüsra","lastName":"Soğanda","suffix":""},{"id":501458692,"identity":"0802377e-d07d-4ef6-9359-b9c70efa24f7","order_by":2,"name":"Muhammed Fatih Baran","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Muhammed","middleName":"Fatih","lastName":"Baran","suffix":""},{"id":501458694,"identity":"365515ac-2a34-4ab4-a989-d030509a8bc3","order_by":3,"name":"Muhammed Şafi Alpaslan","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Muhammed","middleName":"Şafi","lastName":"Alpaslan","suffix":""}],"badges":[],"createdAt":"2025-04-03 16:53:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6371088/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6371088/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89544133,"identity":"71db2796-910e-4d2c-9362-7d791bccd719","added_by":"auto","created_at":"2025-08-21 06:57:45","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":126335,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEarthquake Survivor Status and Social Work Unit Assessment Outcomes\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6371088/v1/b8232e75a66291171c88feb8.jpeg"},{"id":100371409,"identity":"fbf24dcd-7abb-4033-9a80-634c895ec0b0","added_by":"auto","created_at":"2026-01-16 08:10:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1504948,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6371088/v1/082b3b50-89ad-4f4a-bcd1-b672fd28bd6c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Social Work in Emergency Departments: A Multi-Dimensional Analysis of Social Determinants, Interventions, and Outcomes","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEmergency departments (EDs) are critical healthcare providers for individuals experiencing acute medical conditions and trauma (Moore et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Currently, emergency departments (EDs) have become primary points of contact for patients facing social determinants of health, including homelessness, poverty, substance abuse, domestic violence, and mental health disorders (Marks et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; van Tiel et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Social determinants of health (SDoH) encompass the environmental conditions in which individuals are born, live, receive education, work, and experience aging, directly influencing functionality, health, and quality of life. These factors include poverty, discrimination, exposure to violence, food and housing insecurity, and inadequate health literacy (Walter et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). SDoH contributes to disparities in healthcare access, resulting in poorer health outcomes (Bywaters \u0026amp; McLeod, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Walter et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). EDs function as essential safety nets within the healthcare system, serving as a primary access point, particularly for individuals with limited access to medical services (Selby et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In this context, the provision of social work services in EDs is crucial for mitigating the impact of social determinants of health on the healthcare system and promoting holistic patient care.\u003c/p\u003e\u003cp\u003eThe presence of social workers in EDs is essential for improving patient care and optimizing healthcare services (Moore et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Social workers play a essential role in conducting psychosocial assessments, providing crisis intervention, coordinating case management, and referring patients to appropriate community resources (American College of Emergency Physicians, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Kamrujjaman et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These services also encompass addressing significant psychosocial issues such as alcohol and substance abuse, domestic violence, and neglect (Marks, J. et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Allen, Danielle et al., 2024). Moreover, social workers play an pivotal role in providing culturally competent care by advocating for patients' cultural values and acting as intermediaries (Selby, Sasha et al., 2018). However, in many healthcare systems, social workers have not been fully integrated, leading to inefficient utilization of hospital resources (\u0026Ccedil;algı, Berna et al., 2020; Moore, Megan et al., 2017).\u003c/p\u003e\u003cp\u003eThe effectiveness of social work interventions in EDs has been demonstrated in numerous studies. Auerbach and Mason (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) found that these interventions can reduce unnecessary hospital admissions. Similarly, the American College of Emergency Physicians (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) emphasized that social work services are a vital component of the ED, forming an essential part of the healthcare safety net and supporting a broad patient population. Furthermore, Gordon (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2001\u003c/span\u003e) demonstrated the cost-effectiveness of social work interventions through improved hospital resource utilization and overall healthcare cost reduction. However, most existing studies offer only short-term analyses, lacking the comprehensive, long-term evaluations necessary to fully understand the impact of these interventions. To address this gap, a thorough assessment of patients\u0026rsquo; sociodemographic profiles, reasons for ED visits, diagnoses, social work interventions, and discharge outcomes is warranted in the literature.\u003c/p\u003e\u003cp\u003eThe role of social workers in EDs is multifaceted and tailored to the individual needs of patients and their families. Social workers collaborate with physicians, nurses, and other healthcare professionals to address the psychosocial needs of patients in the emergency setting (American College of Emergency Physicians [ACEP], 2011; Moore et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). As part of this interdisciplinary approach, social workers provide emotional support, refer patients to substance abuse treatment resources, assist victims of domestic violence, and facilitate access to essential services such as housing and transportation (Tom et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Yıldırım \u0026amp; Başer, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Furthermore, ensuring continuity of care following ED discharge is also a core responsibility of social workers (ACEP, 2011).\u003c/p\u003e\u003cp\u003eThis study provides a comprehensive and multidimensional analysis of the impact of social work interventions in emergency departments on patient outcomes and the healthcare system. As part of a six-year retrospective analysis, this study examines the impact of social work interventions in EDs on patient care and outcomes, healthcare services, and ED utilization. Additionally, this study explores the challenges and opportunities associated with the integration of social work in EDs and provides recommendations to strengthen the role of social work services in improving patient care and enhancing the efficiency of healthcare delivery.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis retrospective cohort study included patients over the age of 18 who presented to the Emergency Medicine Department of a high-capacity tertiary hospital in T\u0026uuml;rkiye between February 2019 and February 2024, were referred to the social work unit, and underwent a social assessment. Records with missing or insufficient data, as well as repeated consultations for the same patient, were excluded. The study aimed to evaluate the impact of social work interventions on patient outcomes. Variables analyzed included demographic and clinical characteristics, time and reason for admission, social work interventions, diagnoses, and discharge outcomes.\u003c/p\u003e\u003cp\u003eData were retrospectively collected from institutional electronic health records, social work assessment forms, and patient monitoring systems. Ethical approval was obtained from the appropriate institutional review board, and all research procedures were conducted in accordance with the Declaration of Helsinki. Due to the retrospective and anonymized nature of the study, informed consent was waived by the ethics committee.\u003c/p\u003e\u003cp\u003eIndependent variables included age, gender, social security status, marital status, educational level, time of emergency department admission (year, month, day, hour), admission unit, type of admission, and consultation request timing. Dependent variables included the type of social work intervention (e.g., psychosocial support, referral to services, crisis intervention), patient outcomes (e.g., discharge, hospitalization, death, unauthorized discharge), diagnosis, reason for consultation, social work unit assessment, and patient outcome of ED.\u003c/p\u003e\u003cp\u003eData analysis was performed using SPSS version 22.0. Descriptive statistics were reported as frequency, percentage, mean, and standard deviation. The chi-square test was used to compare categorical variables, and a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of the 714 patients\u0026nbsp;included in the study, 48.0% (n=343) were male and the median age was 56 (IQR:37-72). The majority of patients (98.0%) were covered by the Social Security Institution (SGK). Most admissions occurred between 2023 (39.6%) and 2022 (20.2%). The most frequent month of admission was February (16.4%), and admissions were most commonly made between 00:00 and 12:00 (37.4%). A large proportion of patients (86.0%) were managed in the yellow zone, and 94.3% were evaluated on an outpatient basis. The median duration between admission and consultation was 1 day (IQR: 0\u0026ndash;1). Detailed sociodemographic and clinical characteristics are summarized in Table 1.\u003c/p\u003e\n\u003cp\u003eThe most common diagnosis was lack of family support and homelessness (35.0%), followed by physical disorders (28.7%) and assault (20.0%). The leading reasons for consultation were guidance (28.0%) and housing needs (24.9%). Psychosocial counseling was provided in 40.8% of cases, while in 32.8% of consultations, social workers facilitated access to needs and transportation. The majority of patients (88.2%) were discharged from the emergency department. Detailed findings are presented in Table 2.\u003c/p\u003e\n\u003cp\u003eAmong patients consulted between 18:00 and 06:00, the most prevalent social work unit assessment outcome was \u0026apos;not interviewed,\u0026apos; suggesting a greater likelihood of incomplete psychosocial evaluations during nighttime consultation hours. Among patients consulted between 06:00 and 18:00, the most prevalent social work unit assessment outcome was \u0026ldquo;needs met,\u0026rdquo; indicating that daytime consultations were more likely to result in effective service delivery by the social work unit (p \u0026lt; 0.001) (Table 3). Among patients consulted between 18:00 and 06:00, the highest diagnostic rate was observed in cases of sexual abuse. Among patients consulted between 06:00 and 18:00, the highest diagnostic rate was identified in those diagnosed with physical disorders (p \u0026lt; 0.001) (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA total of 589 patients were included in the analysis after excluding individuals who could not be interviewed, left the hospital without permission, or refused treatment, as indicated by the social work unit outcomes. Among those categorized as having received \u0026quot;information,\u0026quot; consultations were most frequently associated with cases of sexual abuse and violence. In contrast, patients whose needs were met or who were admitted to the hospital were predominantly earthquake survivors (p \u0026lt; 0.001) (Table 4). Patients in the \u0026quot;information provided\u0026quot; group most commonly left the hospital without permission, whereas those in the \u0026quot;needs met/inpatient admission\u0026quot; category were primarily hospitalized as their ED outcome (p \u0026lt; 0.001). Regarding diagnostic patterns, the highest rates of sexual abuse were observed among patients who only received information, while physical disorders were most prevalent among those whose needs were met or who were admitted for inpatient care (p \u0026lt; 0.001) (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 5 summarizes the social work assessments of patients consulted for sexual abuse and violence (n=79) and alcohol and substance use (n=19). Psychosocial interviews were the most common intervention in both groups. No statistically significant difference was observed between the groups (p \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003eA total of 644 patients were included in the analysis after excluding those who could not be interviewed based on the social work unit assessments. Among non-earthquake survivors, the most prevalent social work unit assessment outcome was contact with relatives. In contrast, among earthquake survivors, the most frequent assessment outcome was psychosocial interview (p \u0026lt; 0.001) (Figure 1).\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study highlights the critical role of social work services in EDs in influencing both patient outcomes and the healthcare system. The findings emphasize the complex and multifaceted nature of social work practice within EDs and reveal key areas where the development of interventions is needed. The characteristics of 714 patients who required social work support in the ED of a high-volume city hospital were examined, along with the services delivered to them.\u003c/p\u003e\u003cp\u003eThe fact that 52% of the included cases were female and 48% were male suggests that women may have a greater need for social work services. This finding aligns with previous research indicating that women are more frequently represented among frequent users of EDs (van Tiel et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The median age of 56 (range: 37\u0026ndash;72) suggests that individuals in middle and older age groups may particularly require social work interventions in emergency settings. Similarly, Yal\u0026ccedil;ınlı et al. (2021) reported a comparable mean age of 55.6\u0026thinsp;\u0026plusmn;\u0026thinsp;20.3 in their study. These results underscore the importance of developing targeted social work intervention strategies for older adults in emergency departments.\u003c/p\u003e\u003cp\u003eAlthough 98% of the patients were covered by the Social Security Institution, the continued need for social work services suggests that insurance coverage alone is insufficient to address the complex social problems encountered in EDs. This finding reflects the multidimensional nature of social issues observed in emergency care settings. The year-by-year distribution of admissions reveals a clear upward trend, which may be attributed to external factors such as the COVID-19 pandemic and natural disasters (earthquake etc.), as well as internal dynamics like changes in hospital policies. Yıldırım and Başer (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) emphasized the importance of understanding how patient profiles and social work needs evolve over time. Regarding the distribution of admissions by month, a significant concentration was observed in February, likely associated with the earthquakes that struck southeastern T\u0026uuml;rkiye, centered in Kahramanmaraş, on February 6, 2023. The hourly distribution of patient visits indicates that social work needs persist throughout the day. However, the concentration of consultation requests during regular working hours suggests that the absence of social work services during off-hours may contribute to prolonged waiting times in the ED.\u003c/p\u003e\u003cp\u003eFollowing physical pathologies, traumatic events such as physical assault, suicide attempts, and sexual abuse represent significant challenges encountered in EDs. Social workers play a key role in the follow-up of these cases and in directing patients to appropriate services (Marks et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Allen et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In their study, Yal\u0026ccedil;ınlı et al. (2021) identified the most common reasons for social work consultations as housing (36.2%), transportation (30.0%), and guidance (18.9%). While housing and guidance needs aligned with existing literature, a notable proportion of consultations were also related to violence, sexual abuse, and forensic cases. These findings highlight the necessity of integrating social workers into healthcare systems and emphasize their role in improving patients\u0026rsquo; access to psychosocial support. The prominence of social determinants such as inadequate family support and homelessness further reinforces the role of EDs as essential safety nets for public health (Selby et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Moore et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Common social work interventions included psychosocial support (40.8%), contacting family members (25.1%), and addressing basic needs (24.4%). As Tom et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) note, social workers play a key role in helping patients and their families navigate emergency care more effectively. Additionally, Gordon (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2001\u003c/span\u003e) demonstrated the cost-effectiveness of these services, and the model proposed by Bywaters and McLeod (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) offers a valuable framework for understanding their impact on emergency department utilization.\u003c/p\u003e\u003cp\u003eThe hourly distribution and outcomes of social work consultations originating from EDs highlight the clear need for 24/7 social work coverage. The majority of consultations (80.6%) occurred between 06:00 and 18:00. Among patients consulted between 18:00 and 06:00, the highest rate of social work unit assessment was recorded in cases where patients could not be interviewed (37.1%). This suggests that various factors may hinder access to social workers during nighttime hours. Conversely, during the 06:00\u0026ndash;18:00 interval, the highest assessment rates were observed among patients whose needs were met (86.2%) and those for whom contact with relatives was established (84.4%). This may indicate that social workers are more able to address needs such as housing, transportation, and financial assistance during daytime hours. As emphasized by Moore et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), high patient volume and time constraints in EDs can significantly increase the workload of social workers. Therefore, it is essential to ensure adequate institutional support and create appropriate working conditions for social work professionals. Social work interventions in emergency departments must be tailored to meet the specific needs of patients. As noted by Tom et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), social workers should implement a variety of interventions to help patients and their families navigate the ED experience more effectively.\u003c/p\u003e\u003cp\u003eThe high prevalence of sexual abuse and violence cases among patients who received only informational support is noteworthy. In their study, Marks et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) examined how domestic violence is addressed through social work interventions in EDs, emphasizing that early involvement of social workers in honor-based violence (HBV) cases is crucial for the protection and support of victims. Similarly, studies focusing on pediatric emergency patients have highlighted the pivotal role of social workers in identifying and intervening in cases of child abuse and neglect (Bardak et al., 2021). The notable presence of earthquake survivors among patients whose needs were met further illustrates the important role EDs play in disaster response through the provision of social services. Walter et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) emphasized how EDs serve as public health safety nets and the vital role social workers play in meeting the needs of disaster-affected individuals. These findings underscore the essential function of social work in disaster preparedness and response. Among patients who were admitted to inpatient care, psychiatric disorders were frequently observed. This finding reinforces the importance of comprehensive psychosocial assessment and appropriate referral in EDs for individuals presenting with mental health issues. Prior research has highlighted the need to develop early intervention strategies aimed at reducing ED visits among individuals with psychiatric conditions, and that social workers can play a significant role in this process (van Tiel et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Gabet et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Cassarino et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Among those referred to institutional care, inadequate family support and homelessness were particularly prominent, suggesting that EDs must address not only medical but also complex social needs. Additionally, the fact that most patients discharged to their families had been referred due to physical conditions indicates the necessity of supporting and informing caregivers as part of the care process.\u003c/p\u003e\u003cp\u003eAmong victims of sexual abuse and violence, as well as individuals presenting to the ED due to alcohol and substance use, psychosocial interviews emerged as the most common outcome in social work assessments. This underscores the importance of enhancing ED staff\u0026rsquo;s ability to identify and appropriately respond to such cases. As highlighted by Allen et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), emergency personnel require specialized training to effectively support victims of domestic violence. Similarly, Gabet et al. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) emphasized the need for further research on the effectiveness of emergency department interventions targeting individuals with substance use disorders. Ensuring timely referral of these patients to addiction treatment and rehabilitation services is essential. Furthermore, collaboration between EDs, other healthcare providers, and social service institutions must be strengthened to provide coordinated and comprehensive care (Kamrujjaman et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Selby et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAnother notable finding is the high demand for social work interventions among earthquake survivors. It was determined that 96.7% of these patients had their needs addressed through either inpatient hospitalization or referral to supportive services. Psychosocial support emerged as the most commonly identified need among this group. In the aftermath of disasters, psychosocial support and rehabilitation processes are of critical importance. In this context, the findings highlight the necessity of expanding and systematizing crisis intervention protocols within EDs (Kamrujjaman et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Saru\u0026ccedil;, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Given the limited literature on social work interventions for disaster-affected populations, the results of this study offer valuable contributions to understanding the social dimension of post-disaster healthcare delivery.\u003c/p\u003e\u003cp\u003eSocial work practices in EDs support patients\u0026rsquo; healthcare journeys in a more holistic manner by not only providing housing assistance, psychosocial support, and guidance services, but also assuming critical roles in crisis intervention, access to resources, and counseling.\u003c/p\u003e\u003cp\u003eThe retrospective design of this study limits the ability to draw causal inferences. Additionally, the data were collected from a single center, which restricts the generalizability of the findings to other institutions or regions. Furthermore, the absence of certain key data\u0026mdash;such as missing consultation request reasons in some records\u0026mdash;should also be considered a limitation of the study.\u003c/p\u003e\u003cp\u003eThis study highlights the central role of social workers in the delivery of healthcare services within EDs. The findings demonstrate that social work not only enhances individual patient care, but also contributes to the overall efficiency of the healthcare system. For individuals experiencing homelessness, those lacking adequate family support, and patients in need of crisis intervention, the presence of social workers should be considered an essential component of multidisciplinary healthcare. Strengthening social work services in EDs offers not only improved quality of care, but also strategic advantages in terms of resource management and cost-effectiveness for hospitals.\u003c/p\u003e\u003cp\u003eFuture research should comprehensively examine the long-term impacts of social work interventions on patient health outcomes and develop new models to optimize the integration of social workers into EDs. Health policies should aim to expand the role of social workers and promote broader access to these essential services. Ultimately, the integration of social work and medical care will strengthen the role of EDs as a public health safety net and contribute to the advancement of patient care standards.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eM.\u0026Ccedil;. conceptualized and designed the study, supervised data collection, and drafted the main manuscript text. Ş.Y.S. contributed to literature review, interpretation of findings, and manuscript editing. M.F.B. conducted the statistical analyses and contributed to the methodology section. M.Ş.A. supported data extraction and assisted in table and figure preparation. All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eData availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to institutional restrictions and participant confidentiality but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBywaters, P., \u0026amp; McLeod, E. (2003). Social care\u0026apos;s impact on emergency medicine: a model to test. \u003cem\u003eEmerg Med J\u003c/em\u003e,\u003cem\u003e 20\u003c/em\u003e(2), 134-137. https://doi.org/10.1136/emj.20.2.134 \u003c/li\u003e\n\u003cli\u003eMarks, J., Markwell, A., Randell, T., \u0026amp; Hughes, J. (2020). Domestic and family violence, non-lethal strangulation and social work intervention in the emergency department. \u003cem\u003eEmerg Med Australas\u003c/em\u003e,\u003cem\u003e 32\u003c/em\u003e(4), 676-678. https://doi.org/10.1111/1742-6723.13519 \u003c/li\u003e\n\u003cli\u003eMoore, M., Ekman, E., \u0026amp; Shumway, M. (2012). Understanding the critical role of social work in safety net medical settings: framework for research and practice in the emergency department. \u003cem\u003eSoc Work Health Care\u003c/em\u003e,\u003cem\u003e 51\u003c/em\u003e(2), 140-148. https://doi.org/10.1080/00981389.2011.610872 \u003c/li\u003e\n\u003cli\u003eSelby, S., Wang, D., Murray, E., \u0026amp; Lang, E. (2018). Emergency Departments as the Health Safety Nets of Society: A Descriptive and Multicenter Analysis of Social Worker Support in the Emergency Room. \u003cem\u003eCureus\u003c/em\u003e. https://doi.org/10.7759/cureus.3247 \u003c/li\u003e\n\u003cli\u003evan Tiel, S., Rood, P. P., Bertoli-Avella, A. M., Erasmus, V., Haagsma, J., van Beeck, E., Patka, P., \u0026amp; Polinder, S. (2015). Systematic review of frequent users of emergency departments in non-US hospitals: state of the art. \u003cem\u003eEur J Emerg Med\u003c/em\u003e,\u003cem\u003e 22\u003c/em\u003e(5), 306-315. https://doi.org/10.1097/mej.0000000000000242 \u003c/li\u003e\n\u003cli\u003eWalter, L. A., Schoenfeld, E. M., Smith, C. H., Shufflebarger, E., Khoury, C., Baldwin, K., Hess, J., Heimann, M., Crosby, C., Sontheimer, S. Y., Gragg, S., Hand, D., Mcilwain, J.,\u003c/li\u003e\n\u003cli\u003eAmerican College of Emergency Physicians. (2011). \u003cem\u003eSocial work and case management in the emergency department\u003c/em\u003e [White paper]. https://www.acep.org/siteassets/new-pdfs/preps/social-work-and-case-management-in-the-emergency-department.pdf\u003c/li\u003e\n\u003cli\u003eKamrujjaman, M., Demetriou, C., Cuartas \u0026Aacute;lvarez, T., \u0026amp; Castro Delgado, R. (2023). The Role of Social Work for Emergency Medical Services (EMS): A Systematic Review. \u003cem\u003ePrehospital and Disaster Medicine\u003c/em\u003e,\u003cem\u003e 38\u003c/em\u003e(5), 628-635. https://doi.org/10.1017/s1049023x23006143\u003c/li\u003e\n\u003cli\u003eAllen, D., Shaw, K., Mcdonald, P., Schmidt, D., Duncanson, K., \u0026amp; Allan, J. (2024). Enabling Emergency Department Staff to Support Domestic Violence Victims of Strangulation. \u003cem\u003eAustralian Social Work\u003c/em\u003e, 1-15. https://doi.org/10.1080/0312407x.2024.2399562\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;algı, B., Yavuz Erdal, B. r., \u0026Ccedil;akın, E., Dogan, S., \u0026amp; \u0026Ouml;z\u0026uuml;\u0026ccedil;elik, D. a. N. (2020). Hastanede Sosyal Hizmet Uzmanı ve Tıbbi Sosyal Hizmet Farkındalığının Değerlendirilmes. \u003cem\u003eJournal of ADEM\u003c/em\u003e, 1(3), 23-38. \u003c/li\u003e\n\u003cli\u003eAuerbach, C., \u0026amp; Mason, S. E. (2010). The value of the presence of social work in emergency departments. \u003cem\u003eSoc Work Health Care\u003c/em\u003e,\u003cem\u003e 49\u003c/em\u003e(4), 314-326. https://doi.org/10.1080/00981380903426772\u003c/li\u003e\n\u003cli\u003eGordon, J. A. (2001). Cost‐Benefit Analysis of Social Work Services in the Emergency Department: A Conceptual Model. \u003cem\u003eAcademic Emergency Medicine\u003c/em\u003e,\u003cem\u003e 8\u003c/em\u003e(1), 54-60. https://doi.org/10.1111/j.1553-2712.2001.tb00552.x\u003c/li\u003e\n\u003cli\u003eTom, J., Thomas, E. K., Sooraj, A., Uthaman, S. P., Tharayil, H. M., S, L. A., \u0026amp; Radhakrishnan, C. (2023). Need for social work interventions in the emergency department. \u003cem\u003eSoc Work Health Care\u003c/em\u003e,\u003cem\u003e 62\u003c/em\u003e(8-9), 302-319. https://doi.org/10.1080/00981389.2023.2238017\u003c/li\u003e\n\u003cli\u003eYıldırım, B. r., \u0026amp; Başer, A. O. (2019). Acil Servis Tıbbi Sosyal Hizmet M\u0026uuml;dahaleleri, M\u0026uuml;racaat\u0026ccedil;ı Profili Ve Sosyal Hizmet M\u0026uuml;lakatında Dikkat Edilmesi Gereken Durumlar [Emergency Service Medical Social Work Interventions, Client Profile and The Points to Take Into Consideration in Social Work Interview]. \u003cem\u003eToplum ve Sosyal Hizmet\u003c/em\u003e,\u003cem\u003e 30\u003c/em\u003e(1), 286-308. https://doi.org/10.33417/tsh.516859\u003c/li\u003e\n\u003cli\u003evan Tiel, S., Rood, P. P., Bertoli-Avella, A. M., Erasmus, V., Haagsma, J., van Beeck, E.,\u0026hellip;Polinder, S. (2015). Systematic review of frequent users of emergency departments in non-US hospitals: state of the art. \u003cem\u003eEur J Emerg Med\u003c/em\u003e,\u003cem\u003e 22\u003c/em\u003e(5), 306-315. https://doi.org/10.1097/mej.0000000000000242\u003c/li\u003e\n\u003cli\u003eYal\u0026ccedil;inli, S., Karbek Akarca, F., \u0026amp; Yerdelen, B. (2021). Acil serviste tıbbi sosyal hizmet m\u0026uuml;dahalesi gereksinimi olan hastaların retrospektif değerlendirilmesi. \u003cem\u003eEge Tıp Dergisi\u003c/em\u003e,\u003cem\u003e 60\u003c/em\u003e(4), 402-406. https://doi.org/10.19161/etd.1037758\u003c/li\u003e\n\u003cli\u003eMoore, M., Cristofalo, M., Dotolo, D., Torres, N., Lahdya, A., Ho, L.,\u0026hellip;Fouts, S. (2017). When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services. \u003cem\u003eSocial Science \u0026amp; Medicine\u003c/em\u003e,\u003cem\u003e 178\u003c/em\u003e, 104-114. https://doi.org/10.1016/j.socscimed.2017.02.014\u003c/li\u003e\n\u003cli\u003eWalter, L. A., Schoenfeld, E. M., Smith, C. H., Shufflebarger, E., Khoury, C., Baldwin, K.,\u0026hellip;Hess, E. P. (2021). Emergency department\u0026ndash;based interventions affecting social determinants of health in the United States: A scoping review. \u003cem\u003eAcademic Emergency Medicine\u003c/em\u003e,\u003cem\u003e 28\u003c/em\u003e(6), 666-674. https://doi.org/10.1111/acem.14201\u003c/li\u003e\n\u003cli\u003eGabet, M., Armoon, B., Meng, X., \u0026amp; Fleury, M.-J. (2023). Effectiveness of emergency department based interventions for frequent users with mental health issues: A systematic review. \u003cem\u003eThe American Journal of Emergency Medicine\u003c/em\u003e,\u003cem\u003e 74\u003c/em\u003e, 1-8. https://doi.org/10.1016/j.ajem.2023.09.008\u003c/li\u003e\n\u003cli\u003eCassarino, M., Robinson, K., Quinn, R., Naddy, B., O\u0026rsquo;Regan, A., Ryan, D.,\u0026hellip;Galvin, R. (2019). Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review. \u003cem\u003ePlos One\u003c/em\u003e,\u003cem\u003e 14\u003c/em\u003e(7), e0220709. https://doi.org/10.1371/journal.pone.0220709\u003c/li\u003e\n\u003cli\u003eSaru\u0026ccedil;, S. (2015). A General Evaluation about the Medical Social Work in Turkey. \u003cem\u003eTurkish Journal of Family Medicine and Primary Care\u003c/em\u003e,\u003cem\u003e 9\u003c/em\u003e(3), 112-120. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Sociodemographic Characteristics and Emergency Department Admission Details\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.0946%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003cp\u003e52.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e343\u003c/p\u003e\n \u003cp\u003e371\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median (25th-75th percentile)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23.4175%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56 (37-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial Security Status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eSGK (Social Security Institution)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Contracted\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Self-Pay\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e98.0\u003c/p\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e700\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of Admission\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e2019\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2020\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2021\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2022\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2023\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003cp\u003e39.6\u003c/p\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonth of Admission\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;January\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;February\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;March\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;April\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;May\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;June\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;July\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;August\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;September\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;October\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;November\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;December\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003cp\u003e16.4\u003c/p\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003cp\u003e6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime Interval of Admission\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;00:00-12:00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;12:00-18:00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;18:00-24:00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37.4\u003c/p\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003cp\u003e252\u003c/p\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdmission Unit\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yellow Zone\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Red Zone\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e86.0\u003c/p\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e614\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Admission\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eEmergency Examination\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hospitalization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e94.3\u003c/p\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e673\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime Interval of Consultation Request\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;00:00-06:00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;06:00-12:00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;12:00-18:00\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;18:00-24:00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003cp\u003e47.9\u003c/p\u003e\n \u003cp\u003e32.6\u003c/p\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003cp\u003e342\u003c/p\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of Days Between Admission and Consultation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median (25th-75th percentile)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23.4175%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1 (0-1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2035%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0491%;\"\u003e\n \u003cp\u003e714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e: frequency, \u003cstrong\u003e25th-75th percentile\u003c/strong\u003e: first and third quartiles\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Diagnoses (ICD Codes), Reasons for Consultation, Social Work Unit Assessments, Consultation and Patient Outcomes in the Emergency Department\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 3.6005%;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiagnosis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Assault\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Psychiatric disorder\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Physical disorder\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Sexual abuse\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Suicide attempt\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Lack of family support and homelessness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.2364%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003cp\u003e28.7\u003c/p\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason for Consultation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Forensic case\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Housing need\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Alcohol and substance use\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Sexual abuse and violence\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Earthquake survivor\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Suicide attempt\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Guidance\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Communication issue\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.2934%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8742%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial Work Unit Assessment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Needs met\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Not interviewed\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Psychosocial counseling\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Contacted relatives \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.2364%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003cp\u003e40.8\u003c/p\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003cp\u003e291\u003c/p\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConsultation Outcome\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Provided information\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Facilitated access to needs and transportation\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Not interviewed\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hospital admission\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Treatment refusal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.2364%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003cp\u003e32.8\u003c/p\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003cp\u003e6.2\u003c/p\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e311\u003c/p\u003e\n \u003cp\u003e234\u003c/p\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Outcome of Emergency Department\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Death\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hospital admission\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Unauthorized discharge\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Discharged\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.2364%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003cp\u003e88.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e630\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 60.5531%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.2364%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.9682%;\"\u003e\n \u003cp\u003e714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp; \u003cstrong\u003e%\u003c/strong\u003e: Frequency\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Distribution of Social Work Unit Assessments and Patient Admission Diagnoses According to Consultation Time\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"599\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial Work Unit Assessment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e18:00\u0026ndash;06:00\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e06:00\u0026ndash;18:00\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeeds met\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e13.8% (n=24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e86.2% (n=150)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot interviewed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e37.1% (n=26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e62.9% (n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychosocial interview\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e21.0% (n=61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e79.0% (n=230)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContact with relatives\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e15.6% (n=28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e84.4% (n=151)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Admission Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical assault\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e31.5% (n=45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e68.5% (n=98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychiatric disorder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e21.6% (n=8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e78.4% (n=29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical disorder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e13.2% (n=27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e86.8% (n=178)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual abuse\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e42.1% (n=8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e57.9% (n=11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSuicide attempt\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e21.7% (n=13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e78.3% (n=47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of family support and homelessness\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e15.2% (n=38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e84.8% (n=212)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e19.4% (n=139)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e80.6% (n=575)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*p-value based on Chi-square test.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Evaluation of Consultation Reasons, Emergency Department Outcomes, and Admission Diagnoses According to Social Work Unit Outcomes\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"599\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConsultation Reason\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProvided Information\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeeds Met \u0026amp; In-Hospital Admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Forensic case\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e70.8 % (n=34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e29.2% (n=14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"9\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Housing need\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e70.7% (n=106)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e29.3% (n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Alcohol and substance use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e60.0% (n=6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e40.0% (n=4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Sexual abuse and violence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e75.4% (n=49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e24.6% (n=16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Earthquake survivor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3.3% (n=1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e96.7% (n=29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Suicide attempt\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e71.4% (n=15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e28.6% (n=6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Guidance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e36.9% (n=62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e63.1% (n=106)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Communication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e31.6% (n=18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e68.4% (n=39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Other\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e50.0% (n=20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e50.0% (n=20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Outcome of Emergency Department\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Death\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e40.0% (n=2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e60.0% (n=3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Hospital admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.2% (n=1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e97.8% (n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Unauthorized discharge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e66.7% (n=4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e33.3% (n=2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Discharged\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e57.0% (n=304)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e43.0% (n=229)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Patient Admission Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Physical assault\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e65.5% (n=78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e65.5% (n=78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Psychiatric disorder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e39.3% (n=11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e60.7% (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Physical disorder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e38.9% (n=70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e61.1 % (n=110)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Sexual abuse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e83.3% (n=15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e16.7% (n=3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Suicide attempt\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e60.6% (n=20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e39.4% (n=13)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Lack of family support and homelessness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e55.5% (n=117)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e44.5% (n=94)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Total\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e52.9% (n=311)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e47.1% (n=278)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*p-value based on Chi-square test.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Social Work Unit Assessments of Patients Consulted Due to Sexual Abuse and Violence, and Alcohol and Substance Use*\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"596\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial Work Unit Assessment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual Abuse and Violence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol and Substance Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeeds met\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e22.8% (n=18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e15.8% (n=3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot interviewed\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e11.4% (n=9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e26.3% (n=5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychosocial interview \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e54.4% (n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e47.4% (n=9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContact with relatives\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e11.4% (n=9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e10.5% (n=2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*p-value calculated using the Chi-square test.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Emergency departments, Social work, Health services, Vulnerable populations, Social determinants of health, Crisis intervention, Hospital resource utilization","lastPublishedDoi":"10.21203/rs.3.rs-6371088/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6371088/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis retrospective cohort study investigates the role and impact of social work interventions in the emergency department (ED) of a high-capacity urban tertiary hospital in T\u0026uuml;rkiye. The study analyzes data from 714 adult patients referred to the hospital's social work unit between 2019 and 2024. The findings reveal that social workers play a critical role in addressing psychosocial issues, particularly among vulnerable populations such as individuals experiencing homelessness, victims of violence, and disaster survivors. Common diagnoses included lack of family support, physical disorders, and trauma-related conditions. The most frequent interventions involved psychosocial support, facilitation of housing and transportation, and communication with relatives. A statistically significant difference was observed between daytime and nighttime consultations, with fewer patients interviewed and assessed effectively during off-hours, underscoring the need for 24/7 social work coverage. Additionally, survivors of the 2023 T\u0026uuml;rkiye earthquakes showed high rates of unmet psychosocial needs, highlighting the role of ED social work in disaster response. The study concludes that the integration of social workers into emergency care settings enhances patient outcomes, improves care continuity, and optimizes healthcare resource utilization. It recommends policy measures to ensure continuous social work availability in EDs.\u003c/p\u003e","manuscriptTitle":"Social Work in Emergency Departments: A Multi-Dimensional Analysis of Social Determinants, Interventions, and Outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-21 06:57:41","doi":"10.21203/rs.3.rs-6371088/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"daf33a38-a89c-4fcc-9c81-bfbc308e57af","owner":[],"postedDate":"August 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":53260833,"name":"Humanities/Health humanities"},{"id":53260834,"name":"Humanities/Medical humanities"}],"tags":[],"updatedAt":"2026-01-14T13:10:08+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-21 06:57:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6371088","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6371088","identity":"rs-6371088","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}