Competencies Emergency and Mental Health Nurses Need in Triage in Acute Mental Health Care: A Narrative Review

Emergency and mental health nurses are, in many countries, the designated professionals to conduct acute mental health triage. This review aimed to identify competencies these nurses need in major acute health care services such as emergency and accident departments and mental health crisis services for triage for psychiatric patients in crisis.

For familiarization and construction of an initial thematic framework, we have searched the databases MEDLINE, CINAHL, Academic Search Premier, and PsycINFO since 1975. For indexing and sorting, the web-based application Rayyan was used to identify relevant studies. ATLAS.ti 22 was used for data extraction, reviewing, summary, and display using labels relevant for our research questions: knowledge, skills, and attitude. For appraisal of the included studies, the Mixed Methods Appraisal Tool and the Scale of the Assessment for Narrative Reviews were used.

Thirty one studies were included and were overall rated as adequate, mostly published since 2000. Competencies needed by nurses in AMHT contain a high level of specialist knowledge (risk assessment, de-escalation, triage tools, psychopathology, law/regulations, care pathways), skills (clinical skills, communication, collaboration, coordinating care), and attitude (nonjudgmental, confidence).

Emergency and mental health nurses require a significant amount of competencies beyond basic nursing education in acute mental health triage. Most described competencies pertain both to knowledge and skills. Less is known about attitude. To integrate the several competencies knowledge, skills, and attitude, clinical reasoning is needed to organize chaos in unpredictable and complex patient situations.