Reorganising Care within the Emergency Department


The design of emergency departments (ED) and the organisation of care shapes how mental health support is provided to and experienced by people who present with distressing experiences, feelings and emotions.

People described the factors they believe shape the mental health care they receive within ED settings, including the mental health training received by staff, hospital resources, and the physical environment of the ED. Some people said EDs are difficult places in which to receive mental health care because of the busyness of the environment and lack of privacy to discuss distressing experiences, emotions and feelings. While dedicated 24/7 mental health hubs and peer-run crisis centres could facilitate better mental health outcomes, access to these kinds of spaces remains limited at present.

The complexity of the ED and how it relates to other parts of the hospital and the broader mental health system can be difficult to navigate for a person experiencing distressing experiences, feelings, and thoughts. People who have presented to the ED often talked positively about how speaking with a peer worker can be helpful. Peer workers hold experiential knowledge and because of shared experience are able to connect and support people with mental health related concerns. Connecting a person presenting to the ED with a peer worker or advocate can help them to navigate treatment and care possibilities and may help them to feel safe.

Key points

  • The lack of privacy within the ED may mean that some people feel self-conscious when talking about distressing experiences, emotions and feelings.
  • Drawing on and embedding a peer workforce within the ED can facilitate better outcomes for people presenting with a mental health related concern. By drawing on their own lived experience, peer workers are able to provide solidarity and help people to navigate the complexity of the ED and hospital setting.
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Redesigning the emergency department