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I am going to go the Emergency Department tomorrow to try and get myself sorted out. I am really nervous about what to expect. I am going to be honest with them to get the help I need but I am going to stress that I don't want to be hospitalised, because I don't think I need to be. I just want to be getting the right treatment.

So what I was going to ask is, what can I expect when I go to the Emergency Dept??
i can answer you about my experiences in ireland and canada. maybe goldenpsych will see this and can answer about the UK.

first you see the triage nurse. that's like a receptionist. you show your health card adn explain briefly why you are there. i usually just say i'm feeling suicidal. they sometimes say for how long, and i answer (like, a few months, but really bad for a week, that kind of thing).

in my hospital there's a special mental health waiting area. you are escorted there. they take your purse and any stuff you have with you (mp3 player etc), so you don't have anything to hurt yourself with. the nurse comes along and takes your blood pressure and some blood sample for a drug screening, and gives you an ID bracelet. they want to know what drugs you are on, hence the blood test.

next you see an ER doctor. he/she does a brief assessment. what has brought you here, how long have you felt this way. they refer you to the crisis team and the psychiatrist. the crisis team are specially trained social workers and nurses who will interview you in more depth. they will take lots of notes. basically they are assessing if you need to be admitted or not. here if you say you have a definite plan, a date set, and the means at hand (like a stash of pills, etc) then you will be admitted. if you are less definite they will try and set you up with community support, like a cpn or community mental health team. after the crisis team you will see the psychiatrist. that is sometimes a shorter interview, depends who you get. they will take the advice of the crisis team as to whether you should be admitted or not.

it's been my experience that if you don't want to be admitted you can stay out of the hospital by emphasizing that you are not an immediate risk.

generally they don't switch your meds, but refer you back to your GP or psychiatrist for that. they only switch your meds if you are admitted and they can monitor how well they are working. that might not be true everywhere, but it was my experience.

i'm very proud of you for wanting to go to the hospital. you don't have to suffer alone. there is plenty of support out there. glad you are reaching out. be as honest as possible. they can only help you if you open up. if you don't know how to answer something just say you don't know.... they will have plenty of other questions for you.

good luck.


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I know it's easier said than done, but being totally honest with them is it the best thing. I wish I'd been more honest about things in the past. I feel like a hypocrite and I have no room to talk, but I wish you the best. Hugs.


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ONly just seen this. I would have helped if seen it in time. PM me if you want my opinion on stuff. I know a bit from the professional side and a lot from the patient side. Hope I can help in future. x


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I can only talk from the US of A point of view.

Forgive me for saying this, but when you're in an ER, honesty is not the best policy. Here's why. If they decide you're dangerously suicidal, they'll put you in a hospital. The problem is that it could be any hospital. If you run out of luck and all the private hospitals are full, they'll put you in a state hospital (there must be an equivalent to this in the UK, I'd imagine), which will be misery and zero therapeutic value. It's a much better idea to commit yourself voluntarily, so you can pick and choose which hospital you want to stay in.

Now, based on the posts so far, it seems the UK may be more efficient and structured than the US's style, which I think is haphazard and astronomically inefficient. Here's how the US style works: You sit in a waiting room until you see a nurse. You describe your problem to them. You'll be waiting a while after that until you're escorted into the mental health unit. You'll be given somewhere to stay, usually a bay with a bed, and once again, they'll ask you to wait. But, bless their souls, they may give you something to help you relax (in my case, Ativan), which will literally make the experience feel downright pleasant. You'll then get your blood drawn and vitals taken, then you'll wait some more. At some point you'll be seen by a doctor, but he's not the important one. He'll ask you general questions about why you're there, but it's not him you want to win over. After him, you'll see the guy who evaluates you.

This is where it gets touchy. He'll ask you all kinds of questions, the most important being something along the lines of, "Do you feel like you are a danger to yourself or others?" Say yes, and you'll be given a hospital. Say no, and they'll test you some more. So, hypothetically, let's say you say no. You wait some more until another evaluator sees you--but this time, it's in a special area, surprisingly luxurious, and dead quiet. This guy will ask you almost identical questions as the guy before him, but I swear to God he was trained to make you answer yes to that question. He'll question you some more, a lot more, and wear you down. He knows you're dead tired, weary from hours of waiting, and broken-spirited. The interview is lengthy, and by now they'll have drugged you to make you more docile, and thus more truthful. And he'll ask you again, "Do you feel like you're a danger to yourself or others?" The same rules apply.

There aren't that many possible outcomes. Either you're hospitalized or sent home.

There is no such thing as a crisis team in the US. That's something unique internationally.

You really have to walk in determined to get one thing or the other. I was always sent involuntarily, except for once, but it was because I had a different purpose for being there on that one visit.
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