Transferring people with mental illness from emergency department to acute mental health wards: survey of contemporary practice

AIMS AND METHOD A substantial minority of patients attending emergency departments do so with a primary mental health problem. A number will require admission to an acute psychiatric unit. There is little guidance about the best practice in terms of risk assessment and escorting of these patients. We conducted a telephone questionnaire survey of acute trusts, to identify current policies for the transfer of patients with mental illness to acute psychiatric units. RESULTS Eighty-two trusts were contacted. We could not verify the presence of any current policies. There was considerable variation in the assessment and management of risk in these clinical circumstances. CLINICAL IMPLICATIONS Current local service structure and transfer distance may influence the way in which risk is assessed. However, there is a need for trusts to ensure that basic standards of risk assessment are maintained for the transfer of these high-risk patients. We recommend that all emergency departments should have such policies and that liaison psychiatry is well placed to aid their development.