Patients with Mental Health Issues in the Emergency Department: The Relationship Between Coercion and Perceptions of Being Helped, Psychologically Hurt, and Physically Harmed

Abstract

Although patients with mental health issues are increasingly turning to emergency departments to receive mental health services, emergency department staff report being ill-equipped to assist this population. The purpose of this study was threefold. First, we wanted to understand how patients with mental health emergencies who are later admitted to psychiatric units perceived their experience in the emergency department, specifically whether they felt that their experience was helpful or harmful (physically or psychologically) and whether they felt like they were treated differently than patients with medical emergencies. Second, we wanted to understand whether these experiences were impacted by patients' perceptions that they were coerced into seeking treatment. Third, we wanted to gain patients' perspectives on how emergency departments could be modified to better accommodate mental health emergencies. We conducted interviews with 49 patients in an inpatient unit at a large general hospital in British Columbia, Canada, shortly after patients were triaged from the emergency department. We found that roughly half of patients endorsed high levels of feeling helped, with the other half endorsing low levels. Additionally, perceptions of having control over coming to the emergency department were predictive of patients' perceptions of being helped and psychologically hurt.

Keywords:

• emergency department
• coercion
• mental health
• satisfaction