Adelaide University study finds emergency departments failing Australians with psychosocial disability

The Hidden Toll of the Emergency Department on Australians with Psychosocial Disability

A new study reveals a stark reality: 84% of emergency department (ED) visits by people with psychosocial disability occur after hours, when community supports are unavailable. For many, the ED becomes a default—and deeply problematic—option.

The research, published in Emergency Medicine Australasia by Adelaide University, highlights significant gaps in care:

• After-Hours Crisis: The vast majority of presentations happen when dedicated support is closed.
• Missed Connections: Only 34% of patients were asked if they had an NDIS plan. Even fewer—just 25% —were asked what information could be shared with their support networks.
• Compounded Distress: Patients reported that the ED environment itself—noise, bright lights, long waits, and crisis-driven protocols—increased their distress. Some felt disbelieved or stereotyped, and said their physical health concerns were overlooked.
• Clinician Uncertainty: Healthcare workers reported feeling underprepared to manage complex mental health presentations, citing limited training in trauma-informed care and poor access to specialist support.
• A Deeper Risk: A separate related study indicates that the risk of suicide is significantly higher for people discharged from inpatient mental health care than for the general population.

• Psychosocial disability is distinct from a mental health diagnosis. It refers to when a condition like depression, bipolar disorder, or PTSD limits a person's ability to participate in everyday life.
• Approximately 62,000 Australians receive NDIS support for psychosocial disability.

Lead researcher Dr. Heather McIntyre said: "When people with psychosocial disability are in distress after hours, EDs are often the only option, but the environment is extremely challenging."

Senior researcher Professor Nicholas Procter noted: "When the NDIS was established, psychosocial disability was not fully considered, creating a gap in crisis care." He added that some clinicians mistakenly assume the NDIS provides clinical care rather than disability support, leading to the withdrawal of services.

The study calls for systemic change, including:

• More integrated, recovery-focused care models.
• Better after-hours alternatives to emergency departments.
• Stronger coordination between health and disability services.