The average time that a person in a mental health crisis spent in A&E last year was an hour more than in 2023.
Patients who are suicidal or who have self-harmed spent on average nearly 11 hours in A&E last year.
A report from the Royal College of Emergency Medicine finds that despite the standard of care patients received improving, the average time a person in a mental health crisis spent in A&E last year was an hour more than in 2023.
The three-year programme focuses on the level of care these patients are receiving in the A&E from the moment they arrive through the doors of the department and how their experience and quality of care can be improved.
“People in mental health crisis are among the most vulnerable patients our members and their colleagues care for. And the sad reality is that they don’t receive the support they need in our emergency departments,” said RCEM president-elect Ian Higginson.
A 7% rise
Across the UK, 146 emergency departments collated and analysed data, capturing the experiences of almost 20,000 patients who needed urgent care due to self-harm.
Of these patients, 81.8% had a mental health triage when they arrived in the emergency departments to gauge their risk of self-harm and/or leaving the department before an assessment or treatment was complete.
The outcome of this was then used to determine where the patient should be placed in the emergency departments and the level of observation they needed to keep them safe.
That’s an increase of 7% compared to 2023.
Meanwhile, an average of 42.8% of patients considered to be medium or high-risk received an appropriate level of observation during their stay in emergency departments – a significant improvement compared to year one’s mean of 29.1%.
Despite an 8% rise in documented cases of patients receiving compassionate care, 62% lacked evidence of getting this vital level of support while in A&E.
Responsibility of all
Recommendations from the report are that parallel assessment should be encouraged and incorporated into practice, evidence of compassionate and practical care should be captured better, and capacity assessments should be the responsibility of all involved in care and not the sole responsibility of the triage nurse.
Patients leaving before seeing an A&E clinician or adult psychiatric liaison services review should have a follow-up plan arranged and documented.
At a Trust level, the report recommends that safeguarding and drug and alcohol concerns should be considered and addressed in all cases.
“Emergency departments are not the ideal environment for people in mental health crisis – they are busy, noisy, bright and increasingly crowded. And while clinicians will always do what they can to give people the best care possible, the causes and solutions to the problems within our department, lie outside it,” said Higginson.
