Visits to the Emergency Department (ED) for mental health reasons account for 10 to 15% of all visits. Consumers of mental health ED services, however, report that they often feel sent to the back of the queue and that their mental health concerns are not taken seriously, suggesting that societal stigma has impacted their care in the ED. In this paper, we systematically explore the research concerning the attitudes of ED professional staff towards those that present with issues related to mental health. Four themes emerge from the literature: consumer perspectives whose tenor is generally one of negativity; staff-reported attitudes and influencing factors such as age, experience, and confidence in working with mental health presentations; the environmental climate of the ED which may not be conducive to good mental health care; and interventions which have been used to evaluate changes in attitudes.