What to expect if you go to A&E because of self-harm or feeling suicidal
Joy is a youth worker specialising in supporting young people when they are in A&E because of mental health issues or emotional crisis. This is part one of her blog.
Going to A&E is never an indication that someone’s having a great day and it can be even more stressful when you’re there because you’re already feeling that life is too much. Here’s a little walk through what to expect and how to make the best of the situation. For the purposes of this blog, we’ll assume that all other avenues for help and support have been used and that A&E is where you need to be.
So, you walk in the main doors and the first thing you’ll need to do is explain to the person at A&E Reception why you’re there. This may feel a bit awkward but don’t worry, they’re perfectly used to people coming in for all manner of reasons. You don’t have to go into detail, a few words should be enough for them to understand and book you in. If you have someone with you, they can help too.
Depending on the setup of your local A&E and your age, you may be sent to the Paediatric (Children’s) area, or wait in the main waiting area. If it’s busy you could have a while to wait so it’s worth bringing something to do, especially if you’re likely to get anxious, have some distractions handy. You’ll see the Triage Nurse who’ll ask you about why you’re there and record some basic details about you and your family. You’ll likely be asked to go back to the waiting area again while the team decide what needs to happen next. The next person you’ll see will likely be a doctor who will ask you some more detail about what’s been going on for you and how you’re feeling. If you need blood tests the doctor will request these.
It may feel like you’re being asked to tell your story over and over to different people but this is unavoidable I’m afraid. Each medical person you meet will have their own responsibility in relation to your care and they best way for them to make sure they understand exactly how to help you is to ask you personally about things. They will also read the notes that their colleagues have made but there’s no substitute for hearing things first hand, so that’s why there’s so many questions – it’s because they know how important it is to try and understand correctly!
So, once you’ve spoken to a nurse and a doctor in A&E, they’ll be able to decide what needs to happen next. Depending on your situation, you may need medical treatment and if that’s the case the team will arrange that. You may be transferred to a different part of the hospital like the children’s ward or another ward separate to A&E where you’ll have a bed.
The staff basically have two objectives. Firstly, to make sure you are physically well enough to be discharged, they call this being ‘medically fit for discharge’. That’s why they’ll do your ‘obs’ (observations) which is pulse, blood pressure, temperature etc, and blood tests if needed. Secondly, they’ll need to assess your mental health so that when the time comes for you to leave hospital, they are confident that you’re safe to leave and there’ll be a plan in place to support you going forward. This second part is done by a specialist mental health team. This may be CAMHS (Child and Adolescent Mental Health Services) or the Adult Psychiatric Liaison Team who are often referred to as ‘Psych Liaison’. Depending on the hospital, there may be a team that is based in the hospital, or they may come and visit you from outside. In any case, you’ll need to wait to be seen and this may mean staying overnight, especially is you’re waiting to see CAMHS who usually come in the following day.
Okay, so here’s a few top tips to help you get the most out of your chat with the mental health person but the first thing to say is, try not to get stressed if you have a long wait, or if they arrive later than they said they would. It’s not because they took a long lunch or couldn’t be bothered to come on time. It’ll be because they’ve had lots of others to see, or a particularly complicated situation to deal with before they could come to you so cut them some slack, they’re only human!