Journal international sur la santé mentale d'urgence et la résilience humaine

Abstrait

Impact of National Emergency Access Targets (NEAT) on Psychiatric Risk Assessment in Hospital Emergency Departments

Euan R Donley, Rosemary Sheehan

Objective: Hospital Emergency Departments (EDs) are heavily burdened as patient presentation rates rise. To improve patient flow across public hospitals National Emergency Access Targets (NEAT) have been implemented. Individuals who present with mental health concerns attend the ED more often and are generally more complex in their presentation.

Method: This paper examined the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from seven hospital EDs across Victoria, Australia, participated in a mixed methods study via anonymous survey.

Results: NEAT could be helpful. Mental health patients were seen more quickly; less likely to abscond; NEAT can improve teamwork; and, some administrative processes were better streamlined. However, NEAT timelines reduced time with patients and family/carers. This created pressure to rush assessments; was not conducive to professional training, resulted less safe practice, taking shortcuts, hampered rapport, and lacked patient focus.

Conclusions: Patients, who were sober, medically stable, referred early, did not require collateral information, and did not have distressed family/carers, were more likely to be managed within NEAT timelines. Organisational support or training to meet NEAT was negligible. This was exacerbated at times by inadequate mental health staffing, a shortage of mental health beds, and patients' multiple ED presentations.