City Research Online

Psychosocial Assessment in the Emergency Department

Xanthopoulou, P., Ryan, M., Lomas, M. & McCabe, R. ORCID: 0000-0003-2041-7383 (2021). Psychosocial Assessment in the Emergency Department. Crisis, 43(4), pp. 209-306. doi: 10.1027/0227-5910/a000786


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 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 & Psychological Sciences > Healthcare Services Research & Management
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