Mental health in rural and regional emergency departments: An issue of equity of access

For many Australians seeking assistance with mental health problems, the Emergency Department (ED) is the primary point of contact, and it is therefore imperative that emergency services are adequately equipped to assess and manage a wide range mental health related presentations.

This paper discusses the findings of a recent study investigating the mental health triage program of a large regional health network, involving consultation with 7 regional/rural emergency departments, the specialist mental health services, and consumers and carers who accessed the service.

The study found that regional and rural emergency services experience extreme difficulty coping with mental health related presentations. The lack of after-hours specialist mental health expertise, grossly inadequate patient transportation systems, and lack of material resources impact significantly on timely and appropriate treatment for people with mental illness.

EDs reported feeling under pressure to manage a wide variety of high risk presentations without adequate training, support, and safety measures in place. Consumers and carers described excessive wait times and barriers to accessing services, resulting in crisis situations escalating into psychiatric emergencies that may have been avoided with timely intervention.

The lack of adequate mental health resourcing to regional and rural EDs is a well-documented and long-standing problem that amounts to inequitable access to quality healthcare for an already marginalised and stigmatised group of healthcare consumers, and highly challenging work environments for rural and regional emergency healthcare providers.

A/Prof Natisha Sands
Campus Leader, Nursing and Midwifery, Deakin Geelong, Deakin University
 3rd Australian Rural & Remote Mental Health Symposium
“Impacts & Outcomes” – Mercure, Ballarat 14th – 16th November 2011