Attending A&E with Self-Harm or Suicidal Behaviour
We’ve put together some tips to help you through this stressful time and help you get the most benefit from your visit to A&E.
Have a companion with you
Waiting times can be long in the Emergency Department. When you’re attending A&E, it’s helpful to have someone with you to keep you company, to provide support and to help keep you comfortable as you wait to be seen.
- Bring a friend or family member with you or have them meet you at the Emergency Department.
- Your companion may be able to speak up for you – to ask questions, to make requests on your behalf – if you are not in a position to do so yourself.
- Being with someone who cares about you at this difficult time can help you feel supported and help keep you calm, particularly if waiting times are very long. Having a companion when attending A&E can have a calming effect in a stressful situation.
- Where waiting times are excessive, there can be a temptation to leave the A&E without being seen. Research shows that those who are accompanied are more likely to stay to be seen and this improves outcomes.
The A&E can be a very busy environment. You may have to tell your story to a number of people – the receptionist, the Triage Nurse and the clinicians. Understandably, it may be distressing for you to disclose personal and sensitive information in this way.
- Ask for a quiet / private / safe space for your assessment. This may not always be possible, but it’s okay to ask. Privacy is a reasonable request.
- If you don’t feel comfortable asking yourself, this is one of the benefits of having someone accompany you. Your companion can request this on your behalf.
- Due to COVID-19 restrictions, space limitations in A&E may make it less feasible to have a quiet room, but there are other ways that privacy can be respected.
- In the sometimes noisy and often busy environment of the A&E, flagging the need for sensitivity and privacy is a gentle reminder that where space is at a premium, privacy can still be respected.
- If you’re finding it difficult to talk about the way you feel, let them know. This will help them understand and they may be able to prompt you.
On discharge, you should be given a clear idea of what to do next, whether this is a formal plan or recommendations, referral to talk therapy or psychiatric services, guidance on self-care or lifestyle changes or other recommendations. You can take the following steps to ensure you leave with a plan:
- Ask for a follow-up care plan. Again, if you don’t feel able to ask, this is where having a companion is helpful. They can ask on your behalf.
- If there is no formalised care plan, ask what are the “next steps” for you to take on discharge from A&E.
- Where no follow-up care advice is available, ask (or have your companion ask) what should you do as a next step to getting well
- Do they recommend or will they refer you Counselling – HSE or private / subsidised;
- Will they refer you on to other mental health services within the HSE or privately?
- Do they recommend you book an appointment with Pieta or Aware or another voluntary support service;
- Where family members are in a carer role, family should be provided with a care plan and advice on what to do in the event of another crisis situation. If none is forthcoming, they should request this prior to discharge.
- What should you do if you feel like this again? Who should you contact? What steps should you take to keep safe?