title: Review of triage reform: the case for national consensus on a single triage scale for clients with a mental illness in Australian emergency departments.
abstract: OBJECTIVE
  The aim of this paper is to examine the use of mental health triage scales in Australian emergency departments (EDs) and to explore the use of the Australasian Triage Scale (ATS) with existing mental health triage scales.
  
  
  BACKGROUND
  Since the introduction of mainstreaming and deinstitutionalisation in Australian mental health care, the number of clients presenting to Australian EDs has been increasing. It has become apparent that the lack of mental health descriptors in existing triage scales diminishes the ability of ED triage staff to accurately assess clients with a mental illness. In response to this, specialised mental health triage scales have been developed and introduced into practice. Concurrently, mental health descriptors have been incorporated into the ATS used across Australian EDs.
  
  
  METHODS
  A review of English language literature was conducted.
  
  
  METHODS
  The data bases Proquest, Synergy and CINAHL were searched using the key words 'emergency department', 'triage', 'mental health' and again using the term 'emergency mental health triage'.
  
  
  RESULTS
  There is a paucity of literature surrounding the use of mental health triage scales in Australian EDs; 18 articles were found to be directly relevant to the subject matter.
  
  
  CONCLUSIONS
  Currently clients with a mental illness presenting to the ED may be triaged against one of four mental health triage scales. Research has shown that the mental health descriptors in the ATS are not as reliable as a specialised mental health triage scale.
  
  
  CONCLUSIONS
  This has implications for clinical practice on two levels. First, it affects the initial triage assessment in the ED and the ability for mental health clinicians to respond in a timely manner and this will have an impact on clinical outcomes. Second, the use of the mental health triage criteria in the ATS may misrepresent ED workloads and affect data pertaining to ED performance.
authors.affiliation: Central Queensland University, Noosaville BC, Qld, Australia. m.broadbent@cqu.edu.au
authors.forename: Marc
authors.initials: M
authors.lastname: Broadbent
authors.forename: Anne
authors.initials: A
authors.lastname: Creaton
authors.forename: Lorna
authors.initials: L
authors.lastname: Moxham
authors.forename: Trudy
authors.initials: T
authors.lastname: Dwyer
mesh_terms: D001315:Australia; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D018166:Health Care Reform; D001523:Mental Disorders / Q000628:therapy*; D014218:Triage / Q000458:organization & administration*