Abstract
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.
Highlights
The mental health of Canadians is a significant issue, with half of the population likely to experience mental illness by age 40 (Mental Health Commission of Canada, 2013). Winters, Megalhaes and Kinsella (2015) describe the manifestation of mental health crisis through various signs such as agitation, anxiety, or anger which result from feeling overwhelmed or a lack of control
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 Emergency departments (ED’s)
Participants reported a lack of desire to access emergency services in the future
Summary
The mental health of Canadians is a significant issue, with half of the population likely to experience mental illness by age 40 (Mental Health Commission of Canada, 2013). Winters, Megalhaes and Kinsella (2015) describe the manifestation of mental health crisis through various signs such as agitation, anxiety, or anger which result from feeling overwhelmed or a lack of control. 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). There is currently little published Canadian evidence discussing mental health care consumers’ experiences in ED from the clients’ perspective
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