We must integrate services for patients who have mental health issues

It is clear from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report published last month that the current failure by hospitals to integrate physical and mental healthcare means patients with mental health issues are receiving poor care. There are too many examples of these people not being referred to specialist support.

Most emergency nurses will have witnessed the distress and fear that these patients can struggle to live with, usually as a result of depression or schizophrenia. For such people, it is important that the arrival of the liaison psychiatry team is timely.

Failure to record

More worrying, in the emergency departments that NCEPOD studied, there is evidence that patients' mental health conditions were not systematically recorded at triage or at senior review.

Indeed, at an organisational level, systems need to be strengthened to provide joined-up, safe and effective access to care and treatment.

We need better links, for example, between hospitals on the one hand and, on the other, GPs as well as liaison psychiatry, community and hospital mental health providers. This would mean that accurate and timely communication of mental health information, such as relevant history, medication management and possible drug interactions, level of risk and mental capacity to consent to treatment, could be shared more easily.

As the NCEPOD report emphasises, this begins by harnessing the expertise of mental health professionals to shape hospital policy about mental health practice and processes, and by revisiting the composition and role of liaison psychiatry teams.

But emergency nurses could also help by preventing missed opportunities for intervention and escalation of care to more appropriate specialties such as critical care. In this way, they can ensure patients receive an acceptable standard of care and treatment, and that they are prepared for safe and timely discharge.

About the author

Tricia Scott is principal lecturer and emergency care research lead at the Centre for Research in Primary and Community Care, University of Hertfordshire, and consultant editor of Emergency Nurse