Emergency departments and clinical care

Key messages

People who present to the emergency department with mental health issues can expect triage and assessment in a timely fashion.
Consumers can expect treatment and documentation and transfer to the next relevant stage.
Inpatients can expect timely access and those who are discharged can expect appropriate ongoing planning and support.

There are guidelines for minimum standards of care that a person with a mental illness can expect in any Victorian emergency department.

Mental health triage should meet these minimum standards:

People who present to the emergency department with a mental illness are triaged in a timely and appropriate way.
When people presenting with a mental illness have been triaged and are awaiting treatment, the emergency department ensures their safety and that of others in the general waiting area.

Assessment should meet these minimum standards:

The emergency department provides basic mental health assessment, appropriate for people of all age groups and needs.
Assessment starts with and includes the triage process when the person arrives.
Mental health assessment may be conducted by emergency department staff, not just mental health practitioners.
People who present to the emergency department with a mental illness also receive assessment for their physical health.
The emergency department has protocols and linkages in place with specialised mental health services.
Mental health assessment is timely, comprehensive and documented. It includes the patient’s carers, other service providers and other people nominated by the patient where appropriate.
The mental health assessment is conducted using appropriate methods and tools.

Treatment and documentation should meet these minimum standards:

The emergency department uses medication and medical technology that are evidence-based and reflect clinically accepted psychiatric and medical standards.
Emergency department clinical and management protocols describe treatment for common conditions and issues.
Treatment is provided in the least restrictive and most supportive, respectful manner possible, in accordance with the Mental Health Act 2014.
Each person with a mental illness who presents to the emergency department has an individual care plan in their clinical record.
There is appropriate transfer of information between the patient’s emergency department record and other relevant records

Inpatient care should meet these minimum standards:

Handover, transfer and supervision protocols are in place and observed when a mental health patient is transferred from the emergency department to an inpatient ward (general or mental health).
When a patient needs to be admitted and no inpatient bed is available, there is a clear process detailing how to access an appropriate inpatient bed. An escalation policy exists to resolve delays in access to inpatient beds.

Discharge from emergency should meet these minimum standards:

Emergency department clinicians identify and communicate with key service providers or others who will provide follow-up care for people presenting to the emergency department with mental health problems.
A documented discharge plan is communicated to the person, their carers and other healthcare providers, stating specific treatments, ongoing care arrangements and any interim crisis measures.
The emergency department facilitates the involvement of staff, patient and carers with other service providers.

Reviewed 29 May 2015