Adopting a Shared Understanding


Some people who present to the emergency department (ED) with a mental health related concern talk about how they feel shame, embarrassment, and guilt because they can no longer cope on their own and require support. Other people describe how difficult experiences with mental health services in the past mean they are frightened to go to the ED.

People who have presented to the ED often feel that staff focus too much on a diagnosis they may have received, a set of symptoms, or their past history, rather than what their immediate needs are. It can help to validate a person’s experience when staff invite them to describe in their own words what is happening and how they can best be supported. Staff then adopting the language the person uses to describe their distress and needs instead of using clinical language can be experienced as very supportive.

Some people describe it being helpful when staff take the time to talk to them about what care and treatment is available within the hospital. Using clear communication and practicing empathetic engagement help staff to work with individuals who present with mental health related concerns. When staff work with people to set mutual expectations and develop a care plan, it can help to improve healthcare experiences.

Key points

  • Working with people to understand what they are experiencing and using the words they use to explain it can help a person to feel supported.
  • Talking to people about the requirements of the ED and particular staff roles can help to set expectations around care. Explaining why certain things are done and advising people what they can accept or reject can support decision-making.
  • Working with people to develop mutual expectations around treatment and care and making decisions together where possible can help to improve experiences of mental healthcare.
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