A critical discussion of the concept of recovery for mental health consumers in the Emergency Department

Background: The Emergency Department has increasingly become the initial point of contact for mental health crisis assessment and intervention, and is the interface between community and inpatient care. Questions regarding the appropriateness of the Emergency Department in providing a suitable environment for people who have a mental health issue abound with commentary regarding the confidence and competence of general Registered Nurses to provide mental health care. Emergency Departments are busy noisy places where rapid assessments and response is the norm and is counterintuitive to contemporary mental health care. The model of care currently considered best practice in mental health is the Recovery-oriented model; a long term individualised approach to collaborative care. The notion of Recovery as understood and practised in contemporary mental health care is almost polarised to that which is embedded in generalist Emergency Registered Nurses’ practice. As Emergency Departments play an integral role in the assessment of people experiencing mental illness, close collaboration and support is required between emergency and mental health specialities to achieve optimal client outcomes in an environment that is nested within the medical model. Furthermore, Emergency Department staff must be supported in acquiring the knowledge and skills required to care for and manage people with a mental health issue. This includes cognisance and understanding of the Recovery-oriented model of care which is the model of care considered best practice for this client group. This paper offers a critical discussion of the concept of recovery for mental health consumers in the Emergency Department.