The Emergency Department is an important contact point for people with mental health problems (Tobin et al. 1999, p. 2). The Barwon Health Emergency Department is no exception. Approximately 1000 clients per year, or 2.6% of the 38,000 people seen annually in the Barwon Health, Geelong Hospital Emergency Department present with a primary mental health complaint or associated issue. The triage scale used in the Emergency Department contained little guidance for the triage of clients with mental health problems. A triage scale specifically designed to highlight mental health emergencies was implemented and its impact on practice was assessed. Improvements in communication, nurses' confidence in triaging clients with mental health problems and time to intervention by mental health staff were made. This article describes the implementation and evaluation of a mental health triage scale and changes to practice that resulted.