Discharge and Support

Leaving the emergency department (ED) after presenting with a mental health related concern can be a challenging time for people.

Many people we talked to recalled feeling frightened when they were discharged back home because the difficult experiences, feelings and emotions that brought them to the ED were often not resolved. Some people felt they could have benefitted from support for other issues that were contributing to their distress, such as housing insecurity, financial issues or intimate partner violence. It can help a person to feel safe when ED staff take the time to talk about what mental health and other types of supports may be available in the community, including identifying culturally appropriate services and gender specific supports.

People also explained how sometimes they were reluctant to leave the ED when they felt that had not received the support they needed to feel safe. A person may not know what community-based services are available or how to access them, particularly if it is their first time experiencing a mental health related concern. Some people may feel comfortable contacting available community support services on their own, whereas for others this might be more difficult. Developing a care plan and making active referrals into community health and social care services can help to reassure people that support will be available when discharged.

Key points

• Maintaining an up-to-date list of relevant and useful mental health activities and services, including psychosocial supports such as housing, financial and family violence services as well as gender-based and culturally specific supports, available within the local area (or regional catchment area) may help to increase referral options. Inviting these services to talk with ED staff about what they do can help to support mutual learning.
• Inviting people to talk about their distress and explore what they need to feel safe in the community can help ED staff to identify what helpful supports are available to them through health and social care services and explain how they can be accessed.
• An active referral into community health and social care services, accompanied with a written plan for what happens next, may help to reassure a person that support is available to them when discharged from the ED. This can be particularly important for people who may have previously experienced unsatisfactory follow-up support after attending an ED or struggled to find appropriate support.