A&E can be 'dehumanising' for people in suicide crisis

People with lived experience of suicide expressed frustration at services they felt “respond only in crisis” with a lack of preventative structures. Stock picture

People, staff, and organisations affected by suicide all agree that emergency departments (EDs) are “dehumanising and retraumatising” for individuals in a suicide crisis, according to a public consultation.

They said an alternative 24/7 system — such as therapeutic crisis centres — is “essential” to provide a proper service to people in a mental health crisis.

A public consultation commissioned by the Department of Health, with almost 1,900 respondents, also highlighted:

• The need for a “fundamental shift” in focus away from crisis response to prevention;
• The State’s suicide reduction strategy, Connecting for Life, was “well-intentioned but poorly implemented”;
• Services were fragmented and “siloed”, disproportionally affecting rural areas and marginalised communities;
• Particular groups most under-served include people with disabilities, Travellers, people with both mental health and addiction issues, and neurodivergent people.

The results of the consultation, which comprised an online survey and consultation workshops, were published to coincide with World Suicide Prevention Day 2025.

People with lived experience of suicide expressed frustration at services they felt “respond only in crisis” with a lack of preventative structures.

They said EDs are totally inappropriate for people in suicidal distress with people being treated “dismissively or not taken seriously” unless they are able to articulate they have a specific plan to take their lives. People were often discharged without aftercare.

'Fragmented, slow, inequitable'

They described access to services as “fragmented, slow, and deeply inequitable”, marked by delays and the “unavailability” of services in rural areas and the “absence” of out of hours services.

People said the drop off in services after leaving school or moving from child to adult mental health services is a “major vulnerability”, with the risk of suicide increasing.

Overall, people with experience of suicide identified stigma and “silence” around suicide.

Families described inquests are “distressing” and “retraumatising”.

The consultation report said: “Families were frequently left to manage complex care needs alone. The over-reliance on family was seen as both unfair and unsustainable — particularly where families were already struggling with grief, burnout, or trauma.”

HSE staff flagged concern about “growing suicide” risks to youth and online environments, adding that social media and digital platforms “increasingly influence self-harm behaviours”.

What's your view on this issue?

You can tell us here

Staff called for much greater investment in a dedicated suicide prevention workforce. They said EDs are “medically dominated, under-resourced, and not trauma informed”, characterised by “long queues, poor staff training, and a lack of designated safe spaces”.

The HSE noted challenges in working with gardaí, education providers, and NGOs.

A separate consultation with professionals — clinicians, GPs, etc — said there is need for “calm, specialised 24/7 spaces” for suicidal individuals.

GPs said they struggle as child and adolescent mental health services “rejects too many referrals, including for suicidal children”.

• Contact: Samaritans 116 123; Pieta 1800 247 247; yourmentalhealth.ie