City Research Online

Psychosocial Assessment in the Emergency Department.

Xanthopoulou, P., Ryan, M., Lomas, M. and McCabe, R. ORCID: 0000-0003-2041-7383 (2021). Psychosocial Assessment in the Emergency Department.. Crisis, doi: 10.1027/0227-5910/a000786

Abstract

Background: In the United Kingdom, suicide risk is assessed in the emergency department (ED) in a face-to-face assessment with psychiatric liaison practitioners. This study aimed to explore patient experiences of psychosocial assessment after presenting with self-harm/suicidality.

Method: A total of 28 patients were interviewed within 2 weeks of ED attendance for self-harm/suicidality. Interviews were transcribed and analyzed using inductive thematic analysis.

Results: People described two different experiences. A therapeutic interaction was about the "person" and made people feel their life mattered and instilled hope for the future. This was characterized by: unscripted conversation; warmth promoting disclosure; psychological exploration of feelings; validation of distress; and a coproduced care plan. A formulaic assessment was about the "risk" and made people feel their life did not matter and hopeless about the future. This was characterized by: feeling judged and not worthy of help; a focus on risk and form filling; a trivial treatment plan; and loss of trust in services.

Limitations: Our study comprised a single ED and used a non-diverse sample.

Conclusion: Psychosocial assessment in the ED impacts on hope for people in crisis. A focus on therapeutic communication that is about the person, as well as the risk, improves patient experience, decreases distress, and instills hope that life is worth living.

Publication Type: Article
Additional Information: This version of the article may not completely replicate the final authoritative version published in Crisis at https://doi.org/10.1027/0227-5910/a000786. It is not the version of record and is therefore not suitable for citation. Please do not copy or cite without the permission of the author(s).
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine
Departments: School of Health Sciences > Healthcare Services Research & Management
Date available in CRO: 30 Jun 2021 14:02
Date deposited: 30 June 2021
Date of acceptance: 27 December 2020
Date of first online publication: 27 May 2021
URI: https://openaccess.city.ac.uk/id/eprint/26342
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