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Mental health cases at A&E reach crisis level - as waits get longer and specialised beds dwindle


"We've got two," explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room. 

On one wall, there's floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails. There are no other implements in here.

Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves - or others.

"So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we've had two rooms purpose built," Emer says.

"They're as compliant as we can get them with a mental health room - they're ligature light, as opposed to ligature free. They're under 24-hour CCTV surveillance."

There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat.

What is unusual about these rooms is that they are built right inside a busy accident and emergency department.

The doors are just feet away from a nurse's station, where medical staff are trying to deal with acute ED (emergency department) attendances.

On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients.

One, a diminutive South Asian woman, is screaming hysterically.

She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards.

She has been here for 12 hours and wants to leave, but can't as she's being held under the Mental Capacity Act.

Her frustration boils over as she pushes against the chests of the security guards who encircle her.

"We see about 150 to 200 patients a day through this emergency department, but we're getting on average about 15 to 20 mental health presentations to the department," Emer explains.

"Some of these patients can be really difficult to manage and really complex."

"If a patient's in crisis and wants to harm themselves, there's lots of things in this area that you can harm yourself with," the nurse adds.

"It's trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they're not purposeful for mental health patients."

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Source: Sky News, 4 June 2025

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