Emergency room visits increases risk for suicidal patients, study reveals

Some patients in critical need of care who go to an emergency department might be better off not going at all, new research indicates.

EXCLUSIVE

Suicidal patients often have bad experiences at emergency departments and this can stop them from ever seeking help again, mental health advocates have warned.

A new white paper from the Black Dog Institute out today finds attending a hospital ED while in suicidal distress can have a negative impact on people needing help.

Suicidal patients say they’ve been turned away, experienced long wait times of up to eight hours and been exposed to “harmful attitudes”, leaving up to a quarter of patients saying they’d not return to hospital in a future crisis.

“We know from previous research that people in suicide crisis who had a negative experience when they tried to seek help are less likely to seek help again,” Black Dog’s Associate Professor Fiona Shand said.

“Many people didn’t receive follow up treatment after presenting at an emergency department and felt the treatment they received was less than satisfactory.

“Staff in ED’s are often under immense pressure, and that makes it difficult to slow down and meet the needs of someone who is in crisis.”

According to Black Dog, while emergency departments save the lives of people with acute physical illnesses, people experiencing suicidal distress need different kinds of care.

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Emergency departments are not the ideal setting for mental health treatment, according to a new white paper.

“Individuals with lived experience of suicide have indicated the health system often fails to provide effective care,” the paper said, adding that even when best practice is applied, people’s needs often aren’t met.

“Further, many people experiencing suicidal distress never seek help from mainstream services.

“Crisis models of care are largely reactive rather than proactive, but emerging evidence suggests that alternatives to these models, such as safe haven cafes or respite spaces, are required in non-clinical settings and can proactively and respectfully meet the needs of some individuals experiencing crisis.”

The study also noted that emergency and frontline services might be the first point of contact for suicidal patients seeking help – and said the “quality of this interaction” can influence whether people access any support.

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The experience at emergency can determine whether a suicidal patient engages with follow up support.

“Services should be trauma informed, culturally appropriate, and offer integrated services so we are able to better support people’s complex needs wherever they are turning up for help,” Black Dog said in a statement.

The institute has made recommendations on how to better help people experiencing suicidal distress, and integrate these systems into existing health systems to meet what they say is an escalating demand for help from the public.

The paper recommended digital, app-based support, text-based chat support and increased telehealth. The paper also said community based alternatives like the Safe-Haven Cafe at St Vincent’s Hospital in Melbourne had been successful.

It said the Safe-Haven Cafe was a “welcoming space” that offers immediate support to people, and has saved the hospital more than $30,000 every year.

MENTAL HEALTH IN THE PANDEMIC

Black Dog has found more than 80 per cent of people reported their mental health worsened throughout the coronavirus pandemic, and 75 per cent of young people said their mental health had worsened.

BDI said people had reported a number of different concerns, including more than half of respondents reporting a reliance on excessive alcohol use to cope, and with 48.6 per cent of those with a prior history of mental illness, and 54.6 per cent without prior mental health issues.

It also reported more than half of respondents were “really worried” about their financial situation, and said the number of young people with symptoms severe enough for a clinical diagnosis had doubled.