Emotional Journeys through the Emergency Department

When presenting to the emergency department (ED) with a mental health related concern, people often arrive feeling frightened, scared and distressed.

Many people describe how they may present differently to other people when they are experiencing distress. They suggest that their appearance or attempts to describe difficult experiences, feelings, and thoughts may not be a good indication of the level of distress they might be experiencing. People often explain how they can struggle to articulate what they are feeling or attempt to manage how they appear to staff. Some people also describe how they may be cautious when expressing their emotional distress because of poor experiences in the past where they have felt invalidated, dismissed, or threatened by staff. Inviting a person to talk about their experiences can help them to feel safe and heard.

People who have presented to an ED with a mental health related concern often explain how staff responses can have a significant emotional impact. Empathetic and compassionate responses from staff can be reassuring for a person who may be feeling shame, stigma and embarrassment about presenting with a mental health related concern. A lack of communication around treatment decisions or responses from staff that are perceived as dismissive can amplify fears and exacerbate distress. Listening carefully to a person and responding to their requests for support could make a significant difference to how mental healthcare is experienced.

Key points

• Inviting a person to talk about what they are experiencing in their own words can be reassuring.
• Asking a person how they can be best supported can help staff to avoid directing people to inappropriate care that may exacerbate distress because of past experiences. Staff assumptions and interpretations may not accurately reflect what a person is experiencing.
• Active listening and small gestures can help staff to demonstrate care and help to decrease the shame and embarrassment that a person might be feeling about attending an ED.