Psychiatric assessment in the emergency department: preliminary data from consumers about risk assessment following a suicide attempt or deliberate self-harm

Abstract

Suicide continues to be a world-wide problem. For every suicide there are many more suicide attempts and acts of deliberate self-harm. The Emergency Department (ED) of the public hospital is at the forefront of an increasing presentation rate of patients in the acute phase of mental illness or suicide risk, requiring specialised mental health risk assessment. Little is known of mental health patient views about their experience in the ED, yet consumer views are seen as an important factor in measuring the quality of psychiatric assessment and treatment. This paper sets out to examine consumer experiences of psychiatric assessment in the ED. Twenty participants, assessed in one of three public hospital EDs in Melbourne, Australia, following a suicide or deliberate self-harm (DSH) attempt, completed an anonymous online mixed method questionnaire. Participants reported an overall improvement in mood and expressed a positive view of the quality of service from the ED psychiatric team. Most helpful to participants was being listened to, not feeling judged, and having time to talk. What they found unhelpful was the lack of a private area for assessment, feeling ‘labelled’, and at times a lack of individual focus. What became apparent during this study was the difficulty in recruiting participants. A more direct-approach design to encouraging consumers to participate may increase response rates, however, privacy and power dynamics would pose an ethical challenge. Even though participation rate was low, the preliminary message from these ED consumers is still useful in formulating the beginnings of an important conversation with this group.