Pathways to the Emergency Department

Public messaging from mental health organisations and health professionals directs people to the emergency department (ED) when in crisis. A person presenting to the ED with a mental health related concern may be seeking help and support for distress or a space where they can feel safe from difficult experiences, feelings, and thoughts.

The people we spoke to described experiencing several different pathways into the ED when seeking support for a mental health related concern. For some, the ED was the only option available. Others reported seeking help from family and friends, community mental health services and/or their GP before attending an ED as a last resort. Some people described being taken to the ED via police or ambulance without their consent, which could be confusing and frightening. Other people reflected on how past difficult, distressing and unwanted interactions with mental health services have contributed to their fear or reluctance to present to an ED.

A person’s pathway to attending the ED and past experiences may shape how they respond to the environment and interact with staff. Understanding how people have come to the ED and their previous experiences may provide staff with insight into why they might be feeling distressed or scared. Demonstrating empathy and understanding can improve interactions between emergency department staff and people experiencing distress and facilitate better mental health outcomes.

Key points

• People come to the ED with mental health related concerns via a range of pathways.
• Previous challenging experiences of mental health services may influence a person’s feelings about attending an ED.
• Understanding a person’s unique pathway into the ED and inviting them to talk about this can help staff respond to any concerns they might have and demonstrate care and empathy.