Patient Perspectives of Emergency Mental Health Care in a Rural State

Area of Science:

• Mental Health Services Research
• Emergency Medicine
• Rural Health

Background:

• Rising emergency department (ED) visits for mental health conditions strain healthcare systems.
• Prolonged ED boarding (≥24 hours) for mental health patients is a growing concern.
• Limited research exists on patient perspectives of prolonged ED boarding for mental health conditions.

Purpose of the Study:

• To assess patient perspectives on acute mental healthcare experiences.
• To identify challenges faced by individuals with mental health conditions during prolonged ED boarding in a rural setting.

Main Methods:

• Semi-structured interviews with adults (≥18 years) boarding in a general ED for ≥24 hours with a primary mental health condition.
• Thematic analysis of interview data conducted by two independent coders.
• Fifteen patients were interviewed until data saturation was reached.

Main Results:

• Key themes emerged regarding the ED environment, staff and family interactions, care plan communication, patient autonomy, and perceived respect.
• Patients reported significant challenges in accessing timely acute mental healthcare.
• Participants recommended increased in-ED therapy availability and a more welcoming physical environment.

Conclusions:

• Adults in a rural state face substantial barriers to timely acute mental healthcare within the ED.
• Improvements require integrated community, hospital, and statewide strategies.
• Addressing patient perspectives is crucial for enhancing ED mental healthcare quality and policy.