Understanding mental health care experiences in the emergency department using a human factors approach

Hospital emergency departments (EDs) play a critical role in providing acute psychiatric care, however mental health patients and staff report poor care experiences. This study used an ED work domain analysis (WDA), as a framework for understanding care delivery experiences for mental health patients and epistemic experts. Interviews with 29 patients and 16 mental health epistemic experts from two Australian metropolitan hospitals revealed key concerns about care delivery. Patients reported issues including poor communication, unnecessarily repetitive assessments, and patient sensory overload in the ED environment. Epistemic experts described inadequacies of the broader mental health care system, including inadequate community follow-up care and a lack of mental health-specific training for staff. Findings suggest targeted interventions to improve system functions, processes, and environmental factors, ultimately enhancing patient care. Future research can apply this WDA model to other hospitals to improve ED experiences for mental health patients.