Emergency departments - mental health service delivery guidelines

There are guidelines that apply to mental health service delivery in Victorian emergency departments. The guidelines cover the range of service and access, staff training and supervision, safety, legislation, performance management and quality improvement and patient rights.

People who present to the emergency department include those with:

• depression and other mood disorders
• anxiety conditions
• psychotic disorders
• behavioural disturbances associated with substance use
• attempted suicide and other acts of deliberate self-harm
• reactions to personal crises.

People with a mental illness may present with associated or unrelated physical problems, and symptoms of mental illness may be caused by an underlying physical illness.

Service and access guidelines for the emergency department

The minimum standards for service and access are:

• The emergency department responds to all mental health presentations, including psychiatric disorders, behavioural disturbances associated with substance use, and complex psychosocial problems.
• The emergency department ensures access to mental health practitioners and other relevant service providers to meet the needs of people with mental illness or psychosocial problems.
• Roles and responsibilities of mental health practitioners and emergency department clinicians are clearly defined and agreed.

Staff training, development and supervision guidelines for the emergency department

The minimum standards for staff training, development and supervision are:

• A combination of general emergency department clinicians and mental health clinicians provide mental health care in the emergency department.
• The health service regularly identifies development needs of its emergency department staff and provides training for managing people with a mental illness.
• The health service ensures that emergency department staff have access to formal and informal supervision relevant to managing clients with mental health problems.
• Emergency department staff providing mental health care receive specific training in mental health assessment and are supervised by a more experienced colleague.

Safety and environment guidelines for the emergency department

The minimum standards for safety and environment are:

• Policies, procedures and resources promote the safety of people with a mental illness, carers, staff and the community.
• Emergency department staff are regularly trained to understand and respond appropriately and safely to aggressive and other challenging behaviours.

Legislation guidelines for the emergency department

The emergency department operates in line with relevant legislation:

• As part of its duty of care to people presenting with mental illness problems, the emergency department complies with a range of human rights and anti-discrimination legislation and instruments.
• All clinical staff who care for mental health patients must understand and comply with the Victorian Mental Health Act 2014.

Performance management and quality improvement guidelines for the emergency department

The minimum standards for performance management and quality improvement are:

• The health service meets key performance indicator targets for mental health patients through collaborative relationships between the emergency department and other departments.
• The health service monitors performance and uses data collected to improve performance as part of a quality improvement process.

Patient rights, consent and confidentiality guidelines for the emergency department

The minimum standards relating to patient rights, consent and confidentiality are:

• Staff of the emergency department comply with relevant legislation, regulations and instruments protecting the rights of people affected by a mental illness.
• Emergency department staff seek the patient’s informed consent to all treatment, and act in accordance with legal and duty of care obligations if the person is unable, or refuses, to give informed consent.
• The emergency department supports and involves families and carers in the treatment and care of people with a mental illness.
• Only authorised people have access to information about a person with a mental illness.
• Emergency department staff have access to information about health resources available and provide information on how to access relevant services.

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