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Lived Experience of Presenting to the Emergency Department for People with a Psychosocial Disability and an NDIS Plan

Overview

This Australian study explored experiences of 24 people with psychosocial disability and NDIS plans when presenting to emergency departments. Participants reported diagnostic overshadowing, stigma, long waits, and inadequate care. Most would not return voluntarily to EDs, highlighting systemic failures in crisis mental health care delivery.

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Individual authors

  • Heather McIntyre (University of South Australia) - lead researcher who conducted interviews
  • Mark Loughhead (University of South Australia)
  • Laura Hayes (MIND Australia)
  • Nicholas Procter (University of South Australia)

Key insights

Key Insights:

  1. Diagnostic overshadowing: Physical symptoms attributed to mental health history, delaying treatment

  2. Stigma and discrimination: Mental health history led to judgemental treatment

  3. Security creates prison-like atmosphere: Guards increased anxiety and vulnerability feelings

  4. Long waiting times worsen distress: 13-hour waits for psychiatric assessment

  5. NDIS plans lack crisis flexibility: Static plans cannot accommodate fluctuating needs

  6. Most participants wouldn't return: Previous negative experiences deter future help-seeking

  7. Mental health trained staff make difference: Therapeutic engagement improves outcomes

  8. System-wide trauma from crisis services: EDs cause additional harm to vulnerable populations

 

Did this resource draw on transformative evidence?

<p>Yes, this study was heavily based on experiential expertise. It included a lived experience researcher and carer researcher on the team, engaged a lived experience advisory group who co-created interview schedules and analyzed themes, and interviewed 24 people with direct experience of psychosocial disability and NDIS plans presenting to emergency departments. The research prioritized authentic consumer voices and perspectives throughout.</p>
<p>This document incorporated some practice wisdom through initial consultations with clinicians, peer workers, and emergency department professionals who helped establish study aims. However, the primary focus was on lived experience rather than practitioner perspectives. The study aimed to influence clinical practice based on consumer experiences, but did not extensively capture or analyze the practice wisdom of healthcare professionals working in emergency departments.</p>
<p>This document was thoroughly grounded in research and evaluation insights. It employed rigorous qualitative methodology using reflexive thematic analysis, interviewed 24 participants across six Australian states, and followed established research protocols (COREQ standards). The study built on extensive literature review, used systematic data collection and analysis methods, and generated evidence-based themes to inform policy and practice improvements in emergency department care.</p>

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Evidence Summary