Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia.
The ALIVE National Centre for Mental Health Research Translation, The University of Queensland, Woolloongabba, QLD, Australia.
Aust N Z J Psychiatry. 2024 Oct;58(10):839-856. doi: 10.1177/00048674241259918. Epub 2024 Jun 16.
Emergency departments the world over have seen substantial increases in the number of individuals presenting for mental health reasons. However, we have a limited understanding of their experiences of care. The aim of this review was to systematically examine and synthesise literature relating to the experiences of individuals presenting to emergency department for mental health reasons.
We followed Pluye and Hong's seven-step approach to conducting a systematic mixed studies review. Studies were included if they investigated adult mental health experiences in emergency department from the users' perspective. Studies describing proxy, carer/family or care provider experiences were excluded.
Sixteen studies were included. Thematic synthesis identified three themes and associated subthemes. Theme 1 - - comprised: Feeling understood and heard; Engaging in judgement-free interactions; Receiving therapeutic support; Being actively and passively invalidated for presenting to the ED; and Once a psych patient, always a psych patient. Theme 2 - - comprised: Waiting for an 'extremely' long time; and Lacking privacy. Theme 3 was .
The experiences described by individuals presenting to emergency department for mental health reasons were mostly poor. The results illustrate a need for increased mental health education and training for all emergency department staff. Employment of specialist and lived experience workers should also be prioritised to support more therapeutic relationships and emergency department environments. In addition, greater investment in mental health systems is required to manage the current crisis and ensure future sustainability.
世界各地的急诊科都看到了因心理健康原因就诊的人数大幅增加。然而，我们对他们的护理体验了解有限。本综述的目的是系统地检查和综合与因心理健康原因到急诊科就诊的个体的体验相关的文献。
我们遵循 Pluye 和 Hong 的七步系统混合研究综述方法。如果研究从使用者的角度调查了急诊科成人心理健康体验，则纳入研究。描述代理、照顾者/家属或护理提供者体验的研究被排除在外。
纳入了 16 项研究。主题综合确定了三个主题和相关的子主题。主题 1 - 包括：感到被理解和倾听；进行无评判的互动；获得治疗支持；因到急诊科就诊而被主动和被动否定；曾经是精神病患者，永远是精神病患者。主题 2 - 包括：等待“极其”长的时间；缺乏隐私。主题 3 是 。
因心理健康原因到急诊科就诊的个体所描述的体验大多较差。结果表明，需要增加所有急诊科工作人员的心理健康教育和培训。还应优先考虑雇用专门的和有生活经验的工作人员，以支持更具治疗性的关系和急诊科环境。此外，需要对精神卫生系统进行更大的投资，以应对当前的危机并确保未来的可持续性。
