A&E: young people’s experiences of using accident and emergency in Brighton & Hove during a mental health crisis

Young Healthwatch Brighton and Hove carried out this project in 2017 to explore young people's experiences of using Accident and Emergency departments during a mental health crisis. The research combined a survey of 103 young people, interviews with six young people who had attended A&E during a mental health emergency, and a focus group with professionals from ambulance services, police, A&E and community support organisations. Overall, the findings suggested that many young people viewed A&E as a necessary place of safety during a crisis, but often felt it was not the most appropriate environment for mental health support. 

A key finding was low awareness and understanding of available crisis services. Most young people said they had little idea what to expect if they attended A&E during a mental health crisis, and many were unfamiliar with services such as the Mental Health Rapid Response Service (MHRRS) and NHS 111. Young people reported uncertainty about when to seek emergency help and who to contact during a crisis. Long waiting times, noisy and stressful environments, and concerns that A&E staff lacked specialist mental health training were recurring themes. 

Young people who had used A&E often described positive experiences with individual staff members, particularly those who were kind, calm and reassuring. However, many felt unsupported once immediate physical risks had been addressed and reported limited follow-up or onward support after leaving hospital. Several interviewees described feeling that they had been sent home without clear plans, while others reported negative experiences with emergency and mental health services, including not feeling listened to or believed.

Both young people and professionals argued for alternatives to A&E during mental health crises. Common suggestions included dedicated mental health crisis spaces, out-of-hours sanctuaries, specialist mental health staff supporting emergency services, improved crisis planning and better information about available support. Healthwatch concluded that young people need clearer information about crisis services, more appropriate mental health environments, stronger follow-up arrangements and better coordination between emergency, community and mental health services to reduce unnecessary attendance at A&E and improve experiences during times of crisis.