Accident and Emergency


A&E. Accident and Emergency. Emergency.  Just remember that.. it’s important for what follows.

Though it seems that some wish to dissuade people from A&E if they’re in MH crisis. Not in so many words but the message is there.

At Congress #RCN17 there was a motion to discuss lobbying for A&E to NOT be a place of safety in terms of the Mental Health Act 1983. The full motion can be found HERE. I’m sad to say it passed unanimously.

Firstly, there’s no defined “designated” place of safety according to the Act.

Secondly, I would like to know what POSSESSED someone to put this motion forward. It is badly worded. Shows a poor knowledge of the law. Stigmatising. Worrying. (All of these are IMO.. .@MentalHealthCop – Michael has also BLOGGED on the matter which you should read. He says that the RCN’s motion is legally illiterate which is worrying)

I believe this sends out a fairly clear message. Mental health patients do not belong in the A&E department of the hospital. Again; it’s not in so many words and doesn’t address someone attending on their own rather than being detained under a 135/136. But it’s fairly easy to interpret it as DO NOT COME HERE. WE DO NOT WANT YOU. WE CANNOT CARE FOR YOU. (At least that’s what I get from reading the summary…I’m yet to see the video because it won’t work.) Imagine someone who is a member of the disadvantaged and stigmatised group who is already having negative thoughts, poor self worth and they read that nurses do not feel A&E is a safe place for them. They’re not likely to turn up there are they?

I’ve seen arguments from following tweets saying that the nurses are arguing to help MH patients get to a place they can have a safe, calm, therapeutic place to be assessed. Whilst that can be true, it also for some MH patient’s A&E is the only viable option when they’re in crisis. It is even written into the care/crisis plan in some areas where I have been for placement – attend A&E if unable to keep self safe. I have worked in A&E and cared for people

They say the road to hell is paved with good intentions. I don’t disbelieve that my #RCN17 colleagues intended that this was something to be positive. I can see what they were aiming for but this is a BIG miss.

The basis of the motion is NEGATIVE. We should be trying to find the positives in life and our practice. How can we bring about change that helps others. I would have fully welcomed a positive debate on lobbying for a safe place in A&E that IS fit for purpose. Staff A&E with appropriate nurses that CAN care for people who are in MH crisis rather than puzzled and expecting the lone one MH liaison nurse to deal with it (I’ve seen this first hand).  Put THAT motion forward and I will happily support it. Debate what is required for A&E to be a place of safety for ALL (Parity of esteem anybody…hellooo?).

Everyone who comes to A&E is vulnerable. Everyone who comes to A&E is ill. Everyone who comes to A&E needs a therapeutic environment. Let’s talk about changing A&E for ALL rather than excluding the FEW it’s even MORE traumatic for.

Don’t exclude people. Don’t scare them away. Don’t send the message out that A&E should not be a safe place for someone who is in distress.

Be welcoming. Encourage them to seek help. There’s a big campaign about people seeking help… or haven’t you heard.






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