Date of Graduation

Spring 2016

Document Type

Honors Research Project

Degree Name

Bachelor of Science in Nursing


Nursing RN/BSN Akron

Research Sponsor

Lori Kidd PhD, RN, CNS

First Reader

Diane Christensen MSN, RN, CCRN

Second Reader

Lisa Hart MSN, RN, CNE


A problem in healthcare is the increasing number of emergency department visits by repeat users with a comorbid mental illness. These visits increase costs, patient wait times, demand for service, overcrowding, and fragmented care; they may decrease quality of care and effective treatment. The purpose of this study is to identify, review, and critically appraise the evidence about the effect of case management on repeat emergency department (ED) use in those with comorbid mental illness. A systematic review of 21 studies was performed. All explored mental illness, frequent visits to the ED, and interventions. These twenty-one studies were reviewed and formulated into a systematic review, ultimately attempting to determine whether or not people with serious mental illness and comorbid medical conditions over the age of 18 years presenting multiple times to the ED benefit from case management, therefore decreasing their number of visits. Due to a lack of evidence about case management in the ED, the authors recommend further research be done on interventions offered to the seriously mentally ill in general. In addition, research on use of other healthcare facilities, such as urgent care facilities, would be beneficial to identify if any preventative measures are being utilized prior to coming to the ED.