Table 3 Subthemes identified for the main theme – clinician perceptions of mental health patients in ED

A. Mental Health patients in ED as disruptive and a cause of stress/concern

I have concerns about mental health patients who are involuntary, who are say booked to go to [acute facility], who spend a lot of time in ED. I find them –The ones who are in the normal beds, there’s cords, there’s all sorts of stuff around, and that makes me a bit nervous. [Nurse 1]

There have been patients where they have been like psychotic and running around naked and that can be pretty disruptive. Because of that it’s a lot more stressful for the nurses. [Doctor 1]

It’s just moving them through the ED into like a better – for the particularly aggressive and psychotic patients- into like a safer environment for everyone, because they are really disruptive. [Doctor 2]

Is benefit outweighing the risk.... If you put an acute mental health patient next to a two-year-old toddler and the mental health patient’s swearing, and cussing, and carrying one, it’s less than ideal. [Nurse 4]

B. Impact of stigma on mental health patient care

There are certainly people who have a bad attitude towards all mental health, but I think when it comes down to it, I think in this department mental health patients get treated with the compassion and respect they deserve. The attitude is there, but I don’t think the attitude necessarily negatively affects treatment of patients. So, I don’t know if I’d say it’s a problem that needs addressing [Nurse 1]

I do definitely think that like – and I’m a victim to it too, but just the stigma around mental health. It does affect you and then it affects the care for the patient. [Doctor 1]

[With] drug and alcohol issues, and socioeconomic issues, or Indigenous issues, race and things like that... they [other staff] might judge people for what they do instead of being helpful.[Nurse 6]