" A&E an inappropriate place for a mental health patient in crisis"

About: Adult Mental Health and Learning Disabilities / Adult Community Mental Health Teams Leicester Royal Infirmary / Accident and emergency

(as the patient),

We 'Mentals' are told to go to A&E in out of hours even in working hours. For many this is distressing to just go out, My experience has been that 'we' ME are an inconvenience and can expect to wait in a chair as beds "are not for the likes off you".

Why is A&E not supporting mental health patients? There is no care for overdosing and over 8 hours plus wait 'to be seen'. I have witnessed staff and heard staff say about other patients "it's her again" in response to someone clearly in distress. I have listened to a patient asking for water and then having to justify why she wanted some water.

I tried to get the attention of nurses who stand around chatting whilst doctors are rushing around. I then manage to 'catch someone' and ask for some water and ended up apologising when it was a doctor who quite happily got me some despite several nurses still chatting about what happened when them and another nurse had gone out.

Personally I am unusually mentally distressed and then you shove me along to EDU with seemingly no explanation, care or compassion. I believe they should fine LPT when they fail there patients. They need to be made more responsive to crisis.

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Response from Tiffany Jones, Head of Communications & Engagement, University Hospitals of Leicester NHS Trust

Dear Ned

We would like to apologise for your experience and would emphasise that this is not the norm.

Patients who have overdosed, or are suspected of taking an overdose, will not have to wait 8hrs until they are seen as we are targeted to see all patients within 4hrs. Once they have been cleared medically they are then referred to Mental Health services (Crisis Team) which are based here within the Royal Infirmary between 8am-Midnight. Again this service is targeted and they have to see people within 2 hours of referral, out of this time patients are seen by the Psych SHO.

Unfortunately this process can sometimes take longer depending on what time a patient has taken the overdose and whether they need any treatment, but this is usually managed on our Emergency Decisions Unit or medical ward if required.

Patients who need a trolley or a bed are given one as required, as a department we are utilising chairs for the majority of patients who are ambulatory whether they have mental health or physical health problems.

A lot of work has been done within the department to improve the care of individuals with mental health problems. This has included creating a proforma so nursing staff can fast track patients to mental health services who don’t require a medical review, this allows an assessment by mental health services to take place sooner. We are currently in the process of developing a purpose built mental health unit which will contain a waiting area and assessment rooms.

We have a dedicated Mental Health Nurse employed by the department who is continually working to improve standards within the department.

We agree that coming to the Emergency Department can be distressing for patients with mental health problems, however if they have taken an overdose there is no real alternative. If they haven’t taken an overdose then they can always seek help from their GP who can assess and if required arrange an assessment by the Crisis Team without needing to come to the Emergency Department.

We hope that this goes some way to explaining how we are trying to see and treat mental health patients who come to our Emergency Department.

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