Referrals to Inpatient and Outpatient Services

People attending the emergency department (ED) for mental health related concerns may receive only immediate, short-term support or they may be referred to inpatient, outpatient, or community mental health services.

A person might be worried about being in the emergency department (ED) because they do not want to be admitted into a mental health inpatient unit, or because they have had difficult experiences in mental health care services in the past. Many people felt that ED staff often make assumptions about what they are experiencing or what they may need based on their appearance, their pathway into the ED, or their case file notes. They described how these assumptions do not usually reflect what they are experiencing or the type of support they feel would be most helpful. It can help when staff try to understand from a person’s perspective what is happening, even when they appear confused, distressed or tired.

A person may only want immediate short-term support and not want to be referred into an inpatient or outpatient service. Other people may feel that alternative spaces, such as community care units, outpatient services, or peer support settings, are more appropriate alternatives for them than an inpatient unit. A person may feel better supported when they are able to explore options, including referrals into mental health inpatient and outpatient services, with treating teams.

Key points

  • Some people might be uncomfortable about being in the ED because of difficult past experiences with the mental health system or concerns about being referred to an inpatient unit.
  • Creating a space where a person can talk openly about what they are experiencing can help ED staff to establish a connection and communicate what they can do to support them.
  • Finding a way to work with people to establish the most appropriate referral pathway can help to reduce the potential for conflict and improve experiences of care.
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