As reported by the National Health Executive, nearly half of higher-risk mental health patients attending emergency departments were not properly monitored last year, raising fresh concerns about the safety of vulnerable people in crisis care
The data was released during Mental Health Awareness Week as part of the final report from Royal College of Emergency Medicine’s Mental Health and Self Harm Quality Improvement Programme, which ran between 2022 and 2025 and examined how emergency departments care for patients at risk of self-harm or leaving hospital unexpectedly.
The review assessed whether patients received appropriate mental health triage on arrival, whether risk assessments captured key information such as triggers and social circumstances, and whether vulnerable patients were continuously observed while in the department.
While the report found some progress, significant gaps remain. Just 48.6% of high-risk patients were appropriately observed during their emergency department stay in the past year. Although this marked an improvement from 29.1% in 2023 and 42.8% in 2024, RCEM warned the figure remains too low to guarantee safe and consistent care.
Performance also deteriorated during periods of high pressure. In early December 2025, one of the busiest periods for emergency services, observation rates dropped below 35%, highlighting the strain seasonal demand places on frontline care.
The report found that 76.1% of patients presenting after self-harm received a mental health triage assessment on arrival. Documentation standards varied, with 92.1% of cases recording the type of self-harm involved, while only 45.6% included a full social history. Just over half of patients were asked about ongoing thoughts of self-harm.
RCEM said the findings provide a clearer picture of where emergency mental health care has improved, but also underline the need for more consistent standards and stronger support for vulnerable patients attending emergency departments.
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