Abstract:Emergency nurses working in general emergency divisions (EDs) are primarily trained to assess and treat acute physical problems. However, ED nurses often care for psychiatric patients and the perceptions of nurses in EDs regarding their experiences with psychiatric patients have not been well-studied. Using focus groups, the purpose of this study was to explore and describe ED nurses' experiences, and feelings caring for patients with mental illness. Krueger and Casey's qualitative analysis for focus groups wa… Show more
“…Further fuelling the idea of safety risk are reports in studies that GHPs struggle with consumers who self‐harm, seeing self‐harm as counterintuitive, and that self‐harm impairs the functioning of the care process when making this comparison to consumers without mental illness (Hopkins ; Kerrison & Chapman ; Liggins & Hatcher ). One participant in the Plant and White (, p. 244) study captured this conflicting dilemma, stating:These consumers have so many different needs that the medical consumer doesn't have mostly, time and attention. I just don't feel effective with them anymore because I think they abuse the system.…”
Generalist health professionals (GHPs) or those healthcare professionals working in nonmental health facilities are increasingly being required to provide care to consumers with a mental illness. The review aimed to synthesize the qualitative research evidence on the meanings and interpretations made by GHPs (nonmental health professional) who interact with consumers with mental illness in nonmental health settings. A systematic review of the qualitative literature was undertaken for the years 1994-2016. The following electronic databases were searched: CINAHL, MEDLINE, PsycINFO, and Sociological Abstracts. Using narrative synthesis methods, the following themes were identified: mental health knowledge (the GHPs' knowledge level about mental illness and how this impacts their experiences and perceptions); GHPs perceive mental illness as a safety risk (GHPs concern over harm to the consumer and themselves); organizational support (the system response from the environmental design, and expert support and care); and emotional consequences of care (the feelings expressed by GHPs based on their experiences and perceptions of consumers). The results suggest that GHPs provide care in a setting which consists of multiple understandings of what care means. Efforts beyond educational initiatives such as organizational and system-level changes will need to be implemented if we are to progress care for this consumer group.
“…Further fuelling the idea of safety risk are reports in studies that GHPs struggle with consumers who self‐harm, seeing self‐harm as counterintuitive, and that self‐harm impairs the functioning of the care process when making this comparison to consumers without mental illness (Hopkins ; Kerrison & Chapman ; Liggins & Hatcher ). One participant in the Plant and White (, p. 244) study captured this conflicting dilemma, stating:These consumers have so many different needs that the medical consumer doesn't have mostly, time and attention. I just don't feel effective with them anymore because I think they abuse the system.…”
Generalist health professionals (GHPs) or those healthcare professionals working in nonmental health facilities are increasingly being required to provide care to consumers with a mental illness. The review aimed to synthesize the qualitative research evidence on the meanings and interpretations made by GHPs (nonmental health professional) who interact with consumers with mental illness in nonmental health settings. A systematic review of the qualitative literature was undertaken for the years 1994-2016. The following electronic databases were searched: CINAHL, MEDLINE, PsycINFO, and Sociological Abstracts. Using narrative synthesis methods, the following themes were identified: mental health knowledge (the GHPs' knowledge level about mental illness and how this impacts their experiences and perceptions); GHPs perceive mental illness as a safety risk (GHPs concern over harm to the consumer and themselves); organizational support (the system response from the environmental design, and expert support and care); and emotional consequences of care (the feelings expressed by GHPs based on their experiences and perceptions of consumers). The results suggest that GHPs provide care in a setting which consists of multiple understandings of what care means. Efforts beyond educational initiatives such as organizational and system-level changes will need to be implemented if we are to progress care for this consumer group.
“…Patient experiences as consumers of mental health services at EDs has been largely negative (Clarke et al, 2014;Harris et al, 2016). Lack of health care provider awareness of the needs of mental health consumers in the ED results in stigma felt by individuals which results in increased ED visits and admissions and reduces quality of care (Clarke et al, 2014;Gerdtz, Weiland, Jelinkek, MacKinlay, & Hill, 2012;Plant & White, 2013). Environmental factors such as noisy, stimulating, fast paced environments lacking in privacy are cited as factors contributing to poor patient experiences (Clarke et al 2014;Gerdtz, Weiland, Jelinkek, MacKinlay, & Hill, 2012).…”
Purpose: Emergency departments (ED’s) often serve as the access point to health services for individuals living with mental health challenges, with mental health crisis (MHC) accounting for 15% of all presentations to ED’s in Canada. Consumers’ experiences of emergency mental health services have widely been reported as negative. This research aims to explore the experiences of individuals accessing the ED for MHC.
Method: A supra-analysis was conducted using data from four semi-structured interviews collected from a larger study exploring stigma, discrimination and resilience in people experiencing mental health challenges. Supra-analysis aims to explore an aspect of the data from a different theoretical perspective. Transcripts were selected based on a participant history of voluntarily accessing emergency services for MHC. Data analysis was completed using the process of thematic analysis which involved immersion in the data, the development and refinement of codes leading to themes.
Findings: A major theme of abandonment was identified in participant interviews with subthemes of; geographic, socioemotional and therapeutic abandonment. Participants reported that the locations of care, lack of social/emotional engagement and lack of health care providers’ (HCP) knowledge led to negative experiences attending ED’s. Participants also reported a lack of desire to access emergency services in the future.
Conclusion: Future research is vital to enhance the delivery of emergency services, to reduce the feelings of abandonment experienced by individuals accessing the ED for MHC. Training and education must be provided to HCP’s staffing ED’s that focuses on providing high quality, appropriate emergency services to this vulnerable population.
“…One study shows high usage rates occur by patients living alone with limited social networks, who might be better served by nonurgent services [7]. Still other studies make the determination more complex-such as high visit groups related to alcohol use [5], or psychiatric needs [13,14], as well as conditions such as PTSD, mood disorders, and anxiety [15]. One suspected belief often mentioned as a major motivation for patients to use emergency care when not needed, is the belief that patients seek to obtain care without making payment.…”
Section: Use Of Emergency Service When Not Neededmentioning
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