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Emergency Mental Health Innovations Require Evidence Based, Co-designed Approaches

The NHS 10 year plan announced an investment of £120m to develop “mental health emergency departments.”1 Before the plan’s publication, Downs expressed reservations in The BMJ about the unintended consequences of “alternatives to emergency departments,” including the risk of reinforcing the body and mind divide.2 Health professionals have raised similar concerns, and studies have shown that physical health is often overlooked in people labelled as having mental health problems.3In principle, mental health emergency departments positively address Ara Darzi’s assertion that “bright, busy, and noisy A&E departments are completely inappropriate places for someone in mental health distress.”4 But in the context of his report this statement refers to long waiting times in emergency departments, which reflects a problem repeatedly highlighted by the Royal College of Emergency Medicine: crowding. Crowding is best conceived as a flow problem—patient inflow, throughput (emergency department processes), and patient outflow.5 With a focus on inflow, how will...

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Emergency Mental Health Innovations Require Evidence Based, Co-designed Approaches

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