Abstract

In Australia, the number of young people presenting to the emergency department with mental health concerns, in particular, suicidal behaviour (defined here as suicidal ideation, thoughts, intent and attempts) is increasing. Little is known about the experiences of Australian young people who present to hospital emergency departments with suicidal behaviour. In this qualitative study, we conducted a series of focus groups with 55 young people aged 16–25 years, with a view to developing a framework for youth suicide prevention for Western Australia. The data were analysed using a general inductive analysis approach. We explored the experiences and perceptions of the care and management of 35 young people presenting to Western Australian hospital emergency departments. Participants described a range of negative experiences relating to the emergency department environment, staff attitudes and their treatment by staff. We argue that adapting ED practices and approaches to young people presenting with suicidal thoughts and behaviours based on these findings will result in lower rates of repeated presentations and admissions to hospital and lower rates of suicide attempts and deaths by suicide.

Highlights

  • Emergency departments (EDs) play a vital role in treating mental illness

  • This study addresses a gap in the literature by considering young people’s experiences of presenting to EDs with suicidal behaviour

  • The ED provides an opportunity for suicide prevention, but EDs in Western Australia are not currently meeting the needs or providing a safe space for young people presenting with suicidal behaviour

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Summary

Introduction

Emergency departments (EDs) play a vital role in treating mental illness. People seek mental-health-related services in EDs for a variety of reasons, often as an initial point of contact for their mental health concerns or for after-hours care [1]. In Australia, the number of young people with mental health presentations to the ED is increasing, the highest rate being for those aged 18–24 years compared to other age groups (197 per 10,000 population) [2,3]. (The most common age group seeking help with acute mental health conditions from EDs is 15–24 year olds (22%) [4], consistent with most mental disorders emerging by the age of 25 years (62.5%) [5,6]. In Western Australia (WA), where this study was undertaken, a quarter of all attendances to EDs for mental health concerns between 2013 and 2015 were made by young people aged under 23, with suicidal behaviour being the number one.

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