Adults arriving at emergency departments in mental health crisis want to feel cared for and kept safe while they wait for specialist mental health teams, according to a qualitative study published in Frontiers in Health Services. The staff who look after them, meanwhile, want to be able to deliver the level of care patients ought to receive and to safeguard both patients and staff from harm. The research, led by Colleen Cheek of Macquarie University with colleagues from Macquarie University and Western Sydney Local Health District, set out to capture those experiences and to direct future codesign activities for improving emergency department care.
The study used semi-structured interviews with two groups: patients who had presented to an emergency department with mental health issues, and the providers who care for them. In total, the researchers analysed interviews with 29 low-acuity patients and 60 providers. The interviews were analysed thematically to identify areas of common concern, which the team described as touchpoints, alongside the outcomes that each group wanted to achieve.
Interpersonal care emerged as the element patients regarded as most important. In the framework the researchers used, this sits under what is called Collaborative Professional-Patient work. The authors argue that because caring is a central virtue of healthcare professionals and fundamental to patient experience, it deserves more explicit attention in improvement work.
To connect what interviewees said with the practical business of redesigning care, the team applied the Systems Engineering Initiative for Patient Safety, version 2.0, known as SEIPS 2.0.
Mapping the desired outcomes within SEIPS pointed to two concrete directions. For low-acuity presentations, the desired outcomes mapped to emergency department nurse-led early therapeutic support. For patients with, or at risk of, severe behavioural disturbance, they mapped to integrated care within a specialist behavioural assessment unit. The authors present these mappings as a way of targeting codesign activities, not as evaluations of interventions already in place.
The study’s background notes that situating experience in the context of change is recommended in experience-based codesign for healthcare improvement, but that there are few examples using a systems framework that can be tailored to institutional work.
On the provider side, the interviews revealed a parallel set of concerns. Providers wanted to be able to provide the level of care patients ought to receive, and they wanted to safeguard patients and staff from harm. The areas of common concern between these provider priorities and the patient priorities of feeling cared for and kept safe while waiting formed the touchpoints the team identified for codesign.
The authors conclude by contending that making interpersonal care more visible within SEIPS and other quality improvement frameworks may help prevent it being overlooked amid the drive for more efficient clinical processes. Their argument rests on the finding that patients themselves placed interpersonal care at the centre of what mattered most during their emergency department experience.
As a qualitative study using sequential methods and semi-structured interviews, the research describes the perspectives of the patients and providers interviewed and the outcomes they desired; it does not report on the effectiveness of any implemented intervention. The findings are intended to inform and target subsequent codesign work aimed at improving emergency department care for adults with mental health crises.
Subject of Research: A qualitative interview study using the SEIPS 2.0 framework to identify patient and provider priorities for improving emergency department care for adults with mental health crises.
Article Title: Using SEIPS to focus codesign for improved Emergency Department care for adults with mental health crises: a qualitative study using sequential methods
Article References: Cheek, C., Richardson, L., Austin, E., Murphy, M., De Los Santos, A., Vukasovic, M., Hayba, N., Francis-Auton, E., Long, J., Ellis, L., Zurynski, Y., & Clay-Williams, R. (2026). Using SEIPS to focus codesign for improved Emergency Department care for adults with mental health crises: a qualitative study using sequential methods. Frontiers in Health Services, 6, Article 1969943. https://doi.org/10.3389/frhs.2026.1969943
Image Credits: AI Generated
DOI: 10.3389/frhs.2026.1969943
Keywords: emergency department, mental health, qualitative research, SEIPS 2.0, codesign, patient experience, patient safety, interpersonal care, nurse-led support, healthcare improvement, interviews, systems thinking
News Source: Glenn Wilkins. (October 29, 2026). Interviews Map What Mental Health Patients and Emergency Staff Want From Care. Scienmag.
