Integrative review of consumers’ experiences of care in emergency departments for suicidality

Objectives To synthesise evidence on consumers’ experiences of care when presenting to emergency departments (EDs) with suicidal ideation or behaviour. Methods An integrative review of studies published between 2015 and 2026 was conducted using five databases. 18 studies were included and appraised using the Mixed Methods Appraisal Tool. Data were analysed using Whittemore and Knafl’s constant comparative method. Results Four themes were identified: (1) Chaotic and dehumanising ED, (2) relationships and communication which has two subthemes: (2a) helpful approaches and (2b) unhelpful relationships and communication, (3) polarising experiences of assessment and (4) feeling lost and vulnerable: experiences of hospital discharge and follow-up care. Consumers reported long wait times, lack of privacy and pressured atmosphere. Experiences of care were shaped by inconsistent knowledge and treatment from staff ranging from empathetic approaches fostering trust to stigmatising and dismissive behaviour which undermined engagement. Suicide assessments in ED were typically perceived as superficial. Moreover, inadequate discharge preparation, limited care continuity and insufficient follow-up support were identified as issues affecting participants. Conclusions System-level and staff training are needed to enhance engagement, perceived safety and suicide prevention outcomes for consumers experiencing suicidality in emergency settings.