Caring for the mental illness patient in emergency departments—an exploration of the issues from a healthcare provider perspective

Kelli Innes, Julia Morphet, Anthony P O'Brien, Ian Munro
Journal of Clinical Nursing 2014, 23 (13-14): 2003-11

AIMS AND OBJECTIVES: To identify issues, from the emergency department clinicians' viewpoint, with the management of patients presenting to the emergency department with a mental illness.

BACKGROUND: Despite the introduction of several statewide and national initiatives, barriers remain affecting the care and management of consumers presenting with an mental illness to the emergency department. Improving the responsiveness of mental health services, including the provision of more efficient emergency responses for people in crisis, is a key goal. To achieve responsive mental health services in emergency departments, services are required to work together to ensure appropriate referrals between mainstream services and to those services developed to meet the unique needs of specific population groups.

DESIGN: A mixed method approach using surveys and focus groups.

METHODS: Data were collected from patients with mental illness and their next of kin/carers, as well as staff working within the emergency department and the mental health services of the healthcare network.

RESULTS: The study found that there were inconsistencies and deficits in the educational preparation of emergency department staff to manage consumers presenting with mental illness. Further, the inadequate physical environment of the emergency department contributed to difficulties in assessing and managing this group of patients.

CONCLUSIONS: Staff members working within mental health services and the emergency department summarised the key improvement areas as the need for electronic case notes, improvements to the emergency department environment, mental health training, implementation of a referral service and increasing the number of staff.

RELEVANCE TO CLINICAL PRACTICE: Although initiatives have been implemented, there needs to be a greater focus on educating the staff in emergency departments in relation to the policies and strategies which aim to improve the care and management of patients presenting with a mental health problem.

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