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Looking after people with mental health and/or substance misuse problems in emergency departments is not easy
  1. Andrew Molodynski
  1. Oxford Health NHS Foundation Trust, Oxford, UK
  1. Correspondence to Andrew Molodynski, Oxford Health NHS Foundation Trust, Oxford, UK; andrew.molodynski{at}

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Commentary on: Isbell LM, Chimowitz H, Huff NR, Liu G, Kimball E, Boudreaux E. A qualitative study of emergency physicians’ and nurses’ experiences caring for patients with psychiatric conditions and/or substance use disorders. Ann Emerg Med. 2023 Jun;81(6):715–727. doi: 10.1016 /j.annemergmed.2022.10.014. Epub 2023 Jan 18.

Implications for practice and research

  • Emergency departments (EDs) are not the best place for mental healthcare to happen, unless in a genuine emergency.

  • Health and social care systems must focus on providing mental healthcare earlier to prevent ED becoming the default place of intervention.


Emergency department (EDs) play a crucial role in healthcare in most systems internationally. Increasingly, people with mental health problems are attending ED out of desperation and due to inadequate community provision. The environment in EDs is not a good one for such complex and longstanding issues to be properly addressed. Staff can become frustrated, defeatist,and hardened to people presenting …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.