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Response to suicidal patient

Posted By Helpme

"Response to suicidal patient"

About: Royal Melbourne Hospital / Emergency Department

(as a carer),

Called 000 as the patient was suicidal.  I believe suicide is often considered by a patient because they feel that 'nobody cares'. 

Arrived in ED.  I fell staff we saw in the ED did not seem to consider the condition as urgent. Told patient to wait and that they would be seen 'soon' - no timeline provided - no checking in occurred during the wait.  

In my opinion, it seems that without blood, organ failure or broken bones etc (physical conditions), this condition is not considered urgent. 

My impression is that if a patient is mentally haemorrhaging but not visible their condition is not considered urgent.  Waited over an hour and not seen.  No clarity about how long wait could be. I feel nurses throw their hands up in the air.  This led to escalated anxiety on behalf of the patient and increased suicidal thoughts.  

I believe this treatment reinforced the patient's suicidal thoughts as it suggested that 'nobody cares'.  A patient with suicidal thoughts believes that they are not good enough to live and I believe treatment by RMH's staff that we saw reinforced this. 

We left ED as no care was provided.  ED did not follow up - call patient for example.

Was surprised in this day and age that mental health did not seem to be not considered on an equal footing with physical health. The patient was left feeling like a bother and a nuisance and is unlikely to return to ED.  I believe that chances are the patient will suicide at some point. 

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Responses

Response from George Braitberg, Executive Director Strategy, Quality and Improvement, Melbourne Health 4 years ago
George Braitberg
Executive Director Strategy, Quality and Improvement,
Melbourne Health

Submitted on 31/01/2020 at 4:29 PM
Published on Care Opinion at 5:12 PM

picture of George Braitberg

Dear Helpme,

I am very sorry to hear of your experience. I am saddened by your belief that someone without physical signs is not considered to be in as much need as someone who is bleeding. Let me reassure you and those reading your post that we are very concerned about patients in a mental health crisis.

As I do not have any of your specific details I can only provide a general response.

With increasing mental health presentations to Emergency Departments (EDs), including the Royal Melbourne Hospital, several services have been put in place. These include 24-hour mental health clinicians providing assessment and care in the ED and continuous education of ED doctors and nurses in the recognition and management of patients who present with a mental health crisis.

Three years ago, we successfully secured State Government funding and built a 6 bed separated treatment area adjacent to the ED to provide more specialised care for patients with acute mental health needs. We relocated our mental health team, addiction medicine nurses, social worker and homelessness care worker to the area to ensure we could provide safe, timely effective and person-centred care in a better environment. Our results show this has achieved some really good outcomes and as a consequence, we have been selected to be one of 6 hospitals to start a mental health crisis hub that will come on-line in 2021.

We now have 7 days a week psychiatrist rounds in the ED and have been continually reviewing our model to make it work for patients, consumers, families and carers.

Your experience shows us that we still don't get it right all the time and your posting is a timely reminder that our work in this area needs to continue to improve.

I will share your posting with the leadership team in the ED and the acute mental health services and thank you for taking the time to let us know of your experience.

I hope you and the patient did continue to seek the care that they needed and hope that your next experience at the RMH is a more positive one.

Regards,

Prof George Braitberg

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