Service user experiences of attending Accident and Emergency departments for mental health reasons

  • Laura O'Brien-King

Student thesis: Doctor of Clinical Psychology


The aim of this thesis was to explore service user experiences of attending Accident and Emergency (A&E) departments for mental health reasons. The thesis comprises of three separate papers, the contents of which are described below. The first paper presents a systematic review examining service user experiences of attending A&E departments for mental health care. Studies containing quantitative evidence were critically appraised and synthesised. Twenty studies were included and results indicated that service users are often dissatisfied with the care received; although may value accessing mental health liaison services operating within A&E. Service users, predominantly, were not involved within study designs seeking to elicit their feedback. Further research is required which actively involves service users to develop a greater understanding. The second paper presents an empirical study which explored service user experiences of attending A&E for risk to self, from the perspectives of people who experience psychosis. Face-to-face semi-structured interviews were conducted with eleven participants to gather detailed descriptions. Following thematic analysis three themes were identified: ‘feeling unsafe and distressed’, ‘staff interactions’ and ‘future help-seeking’; all of which comprised seven subthemes. Results demonstrate A&E attendances were perceived as inadequate in meeting participants’ needs and compounded their existing distress. Participants experienced a ‘disparity of esteem’ with care provided, found the acute environment intolerable and described staff interactions as pivotal. Experiences of attending A&E influenced attitudes towards further help-seeking. Recommendations for future research and clinical implications are discussed. The final paper presents a critical appraisal of the design, methodology, analysis and conduct of the review and empirical studies. Personal reflections, further discussions of strengths and limitations and implications for future research and clinical practice are provided.
Date of Award31 Dec 2020
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorYvonne Awenat (Supervisor) & Sara Tai (Supervisor)

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