Suffolk User Forum (SUF) and Healthwatch Suffolk, now operating as Knowing Works CIC, have collaborated to gather feedback from people who have sought mental health support in local emergency departments (A&E).
This work set out to refresh the current understanding of people’s experiences and to address a significant gap in independently published evidence about crisis care in Suffolk.
The full report can be downloaded here: Experiences of mental health crisis support at A&E in Suffolk
What people told us
Overall, 20 patients and 19 carers, friends, or relatives responded to the survey.
A&E departments across England are under severe pressure, with average waits far longer than in previous decades. Demand for mental health services has also grown, with many waiting more than a year for first contact.
Difficulties accessing community mental health care can lead to patients frequently accessing crisis services for support. Evidence has also suggested that people with a mental health need often experience the longest wait times in A&E, in part, due to difficulties accessing inpatient mental health beds.
Other key themes and learning included:
People want to feel supported by their visit to A&E. This includes receiving clear advice and guidance and ongoing support or signposting.
- Some patients felt they were unable to access the help or support they needed at A&E. For example, 58% of patients felt A&E treatment had not addressed their mental health needs ‘at all’. Only a quarter said it had helped ‘a lot’.
- Only 50% of patients received information about who to contact if they felt unsafe after their visit.
- People commented about a lack of effective ongoing support for mental health following their visit. For example, one respondent said that they were ‘discharged with a… somebody will call you in 24 hours… but no call [was] received’.
- Four people commented positively about the outcomes or ongoing support people received in A&E and from mental health teams. For example, one patient was referred to an acute inpatient ward, which they felt was an ‘excellent’ place for them.
Providing updates and respectful treatment helps people to feel recognised in moments of crisis.
- Both patients and carers (including friends and relatives) felt their mental health was not recognised, or treated with the same importance as physical health when visiting A&E.
- Half of patients disagreed that their mental health was recognised at triage, or that they were treated with dignity and respect. Others felt they were dismissed by professionals.
- Nineteen people were negative about receiving personalised support in A&E.
- A number of comments said staff were kind, supportive, or sympathetic.
Comfortable seating, access to quiet spaces, and ensuring the availability of food or water is important to patients and carers in crisis.
- People reflected that A&E could be a difficult environment to wait in, with facilities not suited for patients and families in crisis. The key issues included comfort and availability of seating in the waiting room, as well as the noise and busy nature of A&E. A small number of responses reported basic facilities, such as limited access to food and drink whilst waiting.
- Some felt there had been a lack of privacy for triage or assessments. People found it difficult to speak about their needs when other people in the waiting room could hear them.
- A few people commented that A&E had offered a clean environment and privacy when it was needed.
Carers (including friends and relatives) have an important role to monitor people in A&E when staff cannot attend to them, but they have needs too.
- Those supporting a patient in crisis often felt unsupported or overlooked.
- Some people felt ignored or not included in the patients’ treatment or care. They described feeling responsible for keeping the patient safe if they had been discharged without getting the support they needed.
- Only 7% of carers reported staff had offered advice or support to them, and only 14% recalled staff at A&E asking about their wellbeing.