Wait times in an Australian emergency department: A comparison of mental health and non‐mental health patients in a regional emergency department

Abstract

Worldwide, emergency departments in regional and remote areas have a higher per capita mental health presentation rate than their metropolitan counterparts. Evidence suggests that mental health presentations to metropolitan or city emergency departments are exposed to longer waiting times, extended length of stays, and higher rates of access block than non‐mental health presentations. However, there is little research investigating the experiences for mental health and non‐mental health presentations in the emergency department in regional and remote areas. The aim of the current study was to explore wait time and length of stay for mental and non‐mental health patients at a regional emergency department. Audit data from 38,782 presentations to a regional emergency department in NSW over a 12‐month period in 2019 were reviewed. The STROBE cross‐sectional research checklist was adhered to for reporting of results. Time to be seen, length of stay, and access block (length of stay longer than 8 hours) were described and compared for mental and non‐mental health patients. It was found that mental health patients in this study disproportionately experience longer wait times and length of stay in a regional emergency department. Future research is needed to identify whether this issue is present across other Australian regional emergency departments and review funding models to address the discrepancy. These findings make a unique contribution to the literature as previous research focussed on metropolitan emergency departments and only identified time to be seen and length of stay, largely ignoring differences in access block between mental health and non‐mental health patients.

I have not come here because I have nothing better to do: The lived experience of presenting to the emergency department for people with a psychosocial disability and an NDIS plan—A qualitative study

“…While similar outcomes have been reported elsewhere (Carstensen et al., 2017; Johnston et al., 2019; Pascoe et al., 2022; Roennfeldt et al., 2021), people with PSD and NDIS plans experience of EDs draws our attention to the static nature of NDIS plans and their inability to deal with fluctuating condition (Hamilton et al., 2020, 2023). Indeed, although their presentation to the ED has occurred in a desperate attempt to gain assistance, the seriousness of their need is unseen and unacknowledged (Pascoe et al., 2022). Moreover, the sense of discrimination and vulnerability is magnified by the presence of security guards creating a prison like environment.…”

Mapping clinical interactions in an Australian tertiary hospital emergency department for patients presenting with risk of suicide or self-harm: Network modeling from observational data

“…Mental health crisis presentations account for 4% to 10% of ED presentations [12] and are growing in number [13][14][15][16]. This increases strain on EDs [13] and impacts patient flow because mental health presentations typically take more time to assess and staff often report feeling ill-equipped to care for these patients [12].…”

Mapping patient interactions in psychiatric presentations to a tertiary emergency department

“…Mental health crisis presentations account for 4-10% of ED presentations [12] and are growing in number [13,14,15,16]. This increases strain on EDs [13] and impacts patient flow because mental health presentations typically take longer to assess and staff often report feeling ill-equipped to deal with these patients [12].…”

“…Mental health crisis presentations account for 4-10% of ED presentations [12] and are growing in number [13,14,15,16]. This increases strain on EDs [13] and impacts patient flow because mental health presentations typically take longer to assess and staff often report feeling ill-equipped to deal with these patients [12]. Further, EDs are widely understood to be challenging environments for patients affected by mental health issues for reasons including long wait times, noise, lack of privacy, harsh lighting, and negative attitudes of staff [17,18].…”