The characteristics and needs of people who repeatedly present to hospital emergency departments

First published: 09 May 2019 | Last updated: 20 May 2019

Aim: To increase understanding of the characteristics and needs of individuals who repeatedly present to hospital emergency departments with alcohol-related health conditions.

Design: Qualitative interview study.

Setting: Participants were identified from six London emergency departments and interviewed in a range of locations away from the hospital setting.

Participants: 30 Alcohol Frequent Attenders (AFAs): 18 males and 12 females; age range 20 & 68 years.

Measurements: Audio recorded semi-structured interviews.

Findings: Although most participants reported many years of alcohol dependence, there was considerable variation in types and patterns of drinking. The extent and nature of self-reported physical, mental, and housing problems were also diverse. Participants had achieved differing levels of education and had varied employment histories, but most were unemployed at interview. Some had good family and social support whilst others had few pro-social contacts, spending time largely with other drinkers only. Contact with the criminal justice system was minimal. A number of younger women identified themselves as ‘binge drinkers’ and rejected the label of ‘alcoholic’. Some older participants (male and female) concealed their drinking to distance themselves from the image of a ‘tramp on a bench’ or because they felt that alcoholism was not consistent with society’s perception of older people. Whilst a minority denied that they had any alcohol issues at all, most wanted support with both their drinking and other problems.

Conclusions: The current lack of research evidence on the characteristics and needs of AFAs makes this population susceptible to stereotyping and stigma. Our findings show that AFAs comprise a vulnerable yet heterogeneous group. They have diverse needs and support systems, but are frequently concerned about being labelled as ‘alcoholic’. This reinforces the need for personalised forms of care and support that are sensitive to perceived stigma and negative stereotyping.


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Tom Parkman