When mental health and medicine collide: Maintaining safety in the emergency department

Abstract

Mental health patients seeking care through emergency departments (ED) create different challenges for nurses than their medical counterparts. Understanding the special needs of psychiatric populations requires nurses to identify recurring characteristics, subgroups, and demographics. Psychiatric patients share similar traits that hinder their access to health care despite the distribution of mental illness across age, race, gender, and ethnic barriers. Similarities among psychiatric patients include impaired thought processes, tendency to withdraw from social interaction, and shame related to the stigma of mental illness. Psychiatric patients using emergency departments for primary care compound their vulnerable status by circumventing patient-provider relationships that develop when establishing routine practice and familiarity with a primary care physician. This article illustrates how nurses in the American health care system, specifically those in emergency specialties, can respond to environmental challenges while caring for mental health patients. Strategic planning allows ED teams to prepare for an influx of mental health patients and maintain safety as they serve this vulnerable population.