Although all patients who present to ED are triaged and treated, unless they choose to leave prior, a recently released report by the Australasian College for Emergency Medicine (AECM) shows that people presenting with a mental health issue wait longer than other patients to be assessed and treated.
AECM is a professional body for emergency medicine in Australia and New Zealand. Its report, titled The Long Wait: An Analysis of Mental Health Presentations to Australian Emergency Departments, found that people presenting to ED with an acute mental or behavioural condition were 18 percent less likely to be assessed within the appropriate timeframe than people with other medical emergency conditions. In addition, the report found that mental health patients experienced a longer period of treatment and lengthier hospital stays.
According to the report, persons with acute mental and behavioural conditions presenting to the ED for help are more likely to be under 44 years of age. Males are represented slightly higher than females while Aboriginal and Torres Strait Islander people are noticeably over-represented, as are people from remote and regional areas compared with those in major cities. Across Australia mental health patients are twice as likely to leave the ED prior to treatment as other patients, with sometimes fatal consequences. In 2016-2017 around 7,000 people who sought help for a mental health issue left the ED before treatment was completed.
One in seven Australians under the age of 20 experience a mental health condition and over the past few years there has been marked increase in the number of children presenting to ED seeking help for mood, behavioural and emotional disorders. In the state of Victoria, the number of children presenting to ED for a mental health related issue almost doubled from 2008 to 2015.
One of the contributing factors to an increasing number of mental health patients presenting to ED is that there are no other options within their local community. The AECM report found that people experiencing a mental health issue were more likely to arrive at an Emergency Department via ambulance or police / correctional services vehicle than non-mental health patients, accounting for more than 123,000 mental health presentations to Emergency Departments in 2016/17.
Mental health advocacy groups are calling for more specialised care in the community and a more coordinated approach to mental health issues including better support for both ED and primary care health staff to deal with patients experiencing mental health and behavioural issues.