Measuring experiences and outcomes of mental distress-related presentations to Australian emergency departments: lived experience perspectives.

Emergency departments (EDs) represent a key contact point for people experiencing mental health-related distress. Lived experience accounts of presenting to the ED with mental health-related concerns report the ED experience as being highly stigmatizing and negative, with significantly deleterious impacts on people's wellbeing and future help-seeking behaviours being documented. However, little by way of empirical data on these experiences and outcomes are available to help inform evidence-based policy and practice change. This scoping study considered the potential utility of using patient-rated outcome measures (PROMs) and patient-rated experience measures (PREMs) in the Australian ED setting for people who present to an ED with mental health-related concerns. We interviewed eight people, all of whom had reported having presented to an ED for mental health-related reasons. Interviewees considered there being potential merit to measuring patient experiences and outcomes in this setting. Areas of focus for PROMs focussed on whether the presentation led to improvements in the person's health and whether they would return to the ED for future help. Focus areas for PREMs centred around respect for dignity, human rights being upheld, and having health needs met in a timely way. A number of concerns, challenges and opportunities are outlined. These should be used to inform larger-scale qualitative research that aims to develop patient-rated experience and outcome measures specifically for mental health-related ED presentations that are centred on, and are meaningful to, lived experience views and preferences.