Attending A&E

[Lineofduty2021]

For those of you that have attended A&E for your mental health - what was it that happened at that time that made you decide to go? What do they do there? I’m wondering if you have to be suicidal to attend for them to actually do anything?

They don't do anything. A&E is appalling for mental health. I ended up there last week after calling 111. I ended up being restrained, sectioned by police and now I am back home feeling the same anyway.
At best, they sign post you to your local primary liaison service, which you can access through your GP anyway.

You will likely sit for hours on end see their mh team
Who will sign post you and send you back to your go 🤦‍♀️

Gp **

I sprained my wrist last week so had to go and get it checked at a&e a few days ago.

I was there for about 4 hours (xrayed) so saw many people come in and out. Of the people attending there were quite a few that obviously needed help with MH emergencies, from what I saw from the 'Can I help' staff and nurses they were discreet, calm and comforting - one lady was helped in by her husband just before I was called in by the doc to get my wrist strapped who was obviously in so much distress, l told the doctor who was looking past me anyway to see what was going on and she told me to take a seat and immediately rushed past to help her.

I haven't seen this level of care for MH at an a&e before, I've seen some turned away in the past, so was impressed to see they were taking cases seriously.

I spoke to the doctor when she came back and asked if she was okay. She said the increase over the past year in MH emergencies has been so high they've had to dedicate a wing and create a new unit there, but still there just aren't enough beds or staff.

On the one hand I was impressed by the staff, the recognition of need but sad that these people in obvious immediate need still might be sent home, referred or just not seen.

I suppose it really depends on where you attend, luck of the draw on beds when it comes to A&E- I think contacting a charity or specialist service over the phone first to decide the best course of action for help (and to possibly get support in getting it) is the best way to ensure you be seen, and taken seriously.

But from what I saw at A&E, in an emergency, just go- Hope some of that helps?

I was advised by a Health care professional that it’s the best way to be seen by the right team and adjust medications quicker than the GP would.
My mood seems to be jumping from ok to a sudden feeling of overwhelming sadness and that something bad is going to happen. CBT isn’t for 2 weeks.

No, it's not where to go for a meds review. A&E is for mental health crises, not to speed up a referral. Even those in crisis very rarely get the help they need.

Do you feel that you are at immediate risk of serious self harm, or that you pose a risk to others? If so, then A&E is appropriate. If not, book an appointment to see your GP or mental health worker if you have one.

I don’t think I am at immediate risk of serious self harm. Although I’m not exactly sure what’s going on. Nothing makes any sense, I can’t explain what I’m feeling but something isn’t right. I’ve been on sertraline for months now but I’ve never felt like this before. I’m not even sure it’s worth going to the GP because I can’t even make sense of what is wrong or what I need.

Book an appointment with your GP, and if it helps, write down what you've told us. They can ask more questions to decide whether you need a referral or perhaps different medication.

Some areas have a number for emergency mental health support for those not currently under secondary care. Try to find the number online, and make a note of it in case you feel things are becoming more urgent.

It's called accident & emergency. It's not the 'jump the queue because I don't want to wait' department have you had an accident? Is it an emergency? If not, don't go.

@Lineofduty2021

I don’t think I am at immediate risk of serious self harm. Although I’m not exactly sure what’s going on. Nothing makes any sense, I can’t explain what I’m feeling but something isn’t right. I’ve been on sertraline for months now but I’ve never felt like this before. I’m not even sure it’s worth going to the GP because I can’t even make sense of what is wrong or what I need.

Your GP is the best person to see to adjust medication, and they can also see you regularly to monitor how you are getting on with it. The only medication A&E will give you (if any) is a one off benzodiazepine to get you settled enough to go back home.

No personal experience but there being very poor probacy in A and E I did overhear someone who was admitted for just ‘not feeling right.’ The staff were extremely caring and kind. They were asking the lady all kinds of usual questions about feeling dizzy, in any pain etc and she just kept saying no. She just didn’t feel right. Obviously I don’t know if they were able to give any real help or refer her somewhere but they were very kind and understanding at the time.

A+E is only appropriate if you are actively suicidal or if you have seriously self harmed and need medical attention

*privacy not probacy

I have worked for a.and e mental health liaison before and the criteria for admitting someone or offering treatment is SO high, I once had to send someone home with leaflets for local services after they had attempted to stab themselves in the stomach.

Make an appt for you GP and write everything down, ask for an assessment to see if you're eligible for secondary mental health services.
Google if there's any charities near you.
Good luck and hope you feel better soon.

Hi OP, hospital manager here. You will be triaged in A&E and then wait to be seen. You will be seen by a mental health professional. They can be very busy but they will see and assess you. Take some supplies if you can (magazine, drink, snack, medications, charged mobile phone etc) and be prepared to wait for them. They will decide what needs to happen next - admission, medication, referral etc. Please go to A&E if you need mental health help out of hours and you're suffering

I really hate the MN tendency for posters to behave like you should only go to A&E if your arm is literally hanging off and even then you should go in a taxi or get someone to drive you and you should never ring an ambulance.

OP, if you feel like you need to be seen then you should be seen. A&E might be appropriate, but you may find you get a better result from a different service if you can hang on and see GP on Monday. Some areas have mental health hubs where the right teams are based, I’d expect your GP to be able to refer you. You may also find community mental health are able to help. Unfortunately mental health provision is absolutely shocking in lots of areas but you’re not making a fuss about a minor boo boo, if you need to be seen tonight you should go to A&E. They may not be able to give you the best help but they will try and nobody there will judge you for going. They’d rather see you than not.

Also try googling "mental health + your local area". You can wait hours to see someone in A&E (think usual wait time with no priority if no emergency physical health need, then time to refer to Liaison Psychiatry, then wait for them as they may have other assessments)..... but you might have a walk in mental health setting locally where you can get a similar service (qualified nurse, assessment, advice and signposting) with no wait.

I phoned an ambulance because my friend was suicidal and they just took her to a and e, she waited for ages and then they discharged her and sent her home. No help whatsoever. I am frankly amazed that she is still alive.

Thankyou for all your replies. I have been under the crisis team before and having phone appointments with the local team that do the CBT.
I am aware of what A and E is for, I work in a hospital and would never use it as some one put it ‘ to jump the line because I don’t want to wait’. That wasn’t what I meant. The HCP told me our local A and E has a mental health liaison team based there. So if I ever felt like I needed it, it’s the best place to been seen.
It hard to know what the right thing is to do and what I need when nothing in my head makes any sense.

Hope you are ok.
I can relate to. How tour are feeling, in the sense of not really sure what is going on.... Or identify your feelings.
I felt like that when I was months into taking sertraline, and have since after many months of coming of it my. Depression is so much better managed.

Sertealine made me. Very Pooley, but it was a subtle chnahe over time.

I wonder if that drug is doing its job..... I obviously don't know anything other than my experience.
But maybe your gp can just assess u. Even if you can't articulate yourself well, but something def inst right if you are wondering about a+e.
I often wondered myself and realised it was because I would have felt Safer there when my. Mental. Health was clouding everything.

Dd was not eating, they were brilliant, got her on a drip, got a supply of fortified drinks and set up daily home visits - they said if she lived alone they would have sectioned but they released her to us with daily visits instead

It might be worth trying to reframe what it is you think you would want if you went to A&E. What is it you would like them to do? And I don't mean that in a harsh way. I get asked this by the crisis team all the time. What is it you think you need help with?

Trouble is, A&E is there to patch people up so they can move on elsewhere. They are not for long term support or monitoring. That is why some nurses there are dismissive of mental health problems... they can't fix them. They can plaster a broken limb, they can stitch a wound. They can't fix mental health stuff, and that can be frustrating for them.

I do know how difficult it can be. I am no stranger to A&E for MH stuff. They actually help about 10% of the time. The rest just leaves me feeling worse. Is why it is worth trying to reach out to other places... your GP, your local Mind, IAPT, community navigator etc.