A&E Care For Mental Health Must Improve

I have had some positive experiences visiting A&E because of my mental illness, however that is not acceptable, it shouldn’t be some experiences that are positive, it should be all. I shouldn’t feel surprised because it was a rarity that a nurse spoke to me like a human being when in A&E because of my mental illness. It should simply be that all patients feel cared for regardless of whether they are there for mental health or not.

My most detrimental experiences of A&E often involved the triage nurse. It used to take me a while to talk, I would eventually but it might take a few minutes for me to be able to open my mouth and answer the question. I was trying to process the question in my mind and break through the anxiety that often silenced me when I was told to hurry up and not mess about because she has people with real illnesses to see. I felt guilty for being there and ran out of the hospital and didn’t get treatment for my overdose. Another triage nurse asked me if I’d had an accident, I said no and then she asked, is this an emergency? Are you struggling to breathe? I answered no and she told me that I shouldn’t be there then. I was very unwell with mental illness at the time. It isn’t right, the experiences I have put me off attending A&E for mental health or physical health problems relating to my mental health. Health care is supposed to be available to all, it shouldn’t be selective of groups of which they feel they should or shouldn’t treat. Everyone deserves to be treated with dignity and respect. Everyone’s health is important.

An experience that really opened my mind with A&E care was when I turned up with a deep cut that wasn’t self-harm, it was actually inflicted by another person. The A&E staff assumed that it was self-harm and I was left in the general waiting room with no privacy, they treated me on a chair and were speaking to me in a rather harsh manner. When they asked what I had used, I explained the situation to them and they gave me a female nurse instead of a male nurse, allowed me to wait in privacy, a nurse held onto my shoulder comforting me and they spoke to me like a person, we had conversation and laughed as they lightened the mood. The difference in the care and interaction shocked me, as a mental health patient they wanted to get me back out the door, as a physical health patient they wanted to make sure I was okay. It was shocking.

There seems to be this view in A&E that mental illness is not ‘real’ illness and is not deserving of emergency care. Mental illness is as real as physical illness and if we look at it this way, a mental health crisis is more threatening to an individuals’ life than a broken leg. There are often comments of, “You did this to yourself”, I mean “deliberate self-harm” what a horrible phrase, nobody decides that their life aims are to self-harm, no one wants to feel that way and do such horrible things to themselves. The patient is not just ‘another self-harmer’, people self-harm for different reasons. For one patient they may self-harm for control but it goes too far and they end up in A&E it may not be a suicide attempt or a cry for help but for others that may be the case. A patient who breaks his leg snowboarding is not the same as an elderly patient who fell and broke her leg. Each patient is an individual. Mentally unwell patients shouldn’t be grouped and generalised by staff.

A&E staff should not be telling patients that they chose to be there when they are attending A&E for mental illness. If someone with a mental illness has chosen to be there then so has nearly everyone in that waiting room, a snowboarder chooses to snowboard and knows the risk, it could be argued that they chose to be in A&E by choosing to do a risky sport. Nobody chooses to end up in A&E, no one wants to be unwell or sit in a waiting room full of ill and injured strangers for hours on end.

A&E care shouldn’t be exclusive, it should be there for all and no matter what the illness or injury is, the care and interaction should stay at the same level. Patients with mental health problems should be treated the same as anyone else in A&E and should not be made to feel like they cannot attend the department in times of need. Stigma should not exist within the health care system.


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