Abandonment: Experiences of accessing emergency services during mental health crisis

Abstract

Purpose: Emergency departments (ED’s) often serve as the access point to health services for individuals living with mental health challenges, with mental health crisis (MHC) accounting for 15% of all presentations to ED’s in Canada. Consumers’ experiences of emergency mental health services have widely been reported as negative. This research aims to explore the experiences of individuals accessing the ED for MHC.
 Method: A supra-analysis was conducted using data from four semi-structured interviews collected from a larger study exploring stigma, discrimination and resilience in people experiencing mental health challenges. Supra-analysis aims to explore an aspect of the data from a different theoretical perspective. Transcripts were selected based on a participant history of voluntarily accessing emergency services for MHC. Data analysis was completed using the process of thematic analysis which involved immersion in the data, the development and refinement of codes leading to themes.
 Findings: A major theme of abandonment was identified in participant interviews with subthemes of; geographic, socioemotional and therapeutic abandonment. Participants reported that the locations of care, lack of social/emotional engagement and lack of health care providers’ (HCP) knowledge led to negative experiences attending ED’s. Participants also reported a lack of desire to access emergency services in the future.
 Conclusion: Future research is vital to enhance the delivery of emergency services, to reduce the feelings of abandonment experienced by individuals accessing the ED for MHC.
 Training and education must be provided to HCP’s staffing ED’s that focuses on providing high quality, appropriate emergency services to this vulnerable population.