Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T13:15:05.684Z Has data issue: false hasContentIssue false
  • English
  • Français

Staff Perspectives of Emergency Department Pathways for People Attending in Suicidal Crisis: A Qualitative Study

Published online by Cambridge University Press:  07 July 2023

Molly McCarthy ,
Rajan Nathan ,
Jason McIntyre ,
Emma Ashworth  and
Pooja Saini
Molly McCarthy*
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Rajan Nathan
Affiliation:
Cheshire & Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
Jason McIntyre
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Emma Ashworth
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Pooja Saini
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
*
*Corresponding author.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims

Background: The number of suicide-related presentations to emergency departments (EDs) has significantly increased over recent years; thus, making staff often the first point of contact for people in suicidal crisis. Despite this, staff receive minimal psychiatric training and few opportunities for education on the treatment and management of people presenting in suicidal emergencies. Understanding the needs of those who work within EDs is key to maximising the opportunity to reduce suicidal behaviour. Aims: To examine staff perspectives and experiences of working with people presenting to emergency departments in suicidal crisis.

Methods

Qualitative study guided by thematic analysis of semi-structured interviews with ED administrative, medical and mental health staff.

Results

Twenty-three staff participated. Three key themes were identified: (1) factors influencing staff decision-making; (2) quality of care for both staff and patients; (3) staff burnout, mental health and well-being. Staff described an overall lack of confidence and training related to asking patients about suicidal thoughts, which resulted in defensive practice and risk adverse decision-making. Quality of care for both patients and staff were discussed in relation to availability of resources, staffing pressures and team collegiality.

Conclusion

Staff felt inadequately equipped to deal with suicide-related presentations. Organisational support is lacking with increased staffing pressures, poor service availability and lack of beds. Negative staff attitudes often reflected an inherent unintentional use of language. Changing ED culture from top-down is imperative to address negative language and behaviours towards suicidal crisis and improve patient pathways and experience. Mandatory and ongoing training is needed to improve staff confidence, knowledge and attitudes.

Type
Research
Information
BJPsych Open , Volume 9 , Supplement S1: Abstracts from the RCPsych International Congress 2023, 10–13 July , July 2023 , pp. S61
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

Submit a response

eLetters

No eLetters have been published for this article.