Mental health-related learning needs of clinicians working in Australian emergency departments: a national survey of self-reported confidence and knowledge

Abstract

Objective: To identify the mental health-related learning needs of doctors and nurses working in Australian EDs.

Methods: A purpose-designed survey was developed, and face validity was verified by 12 doctors and nurses. A cross-sectional survey of a national sample of nurses and senior doctors (registrars and consultants) working in EDs across Australia was then undertaken. The survey consisted of 130 items and required approximately 20 min for completion. The survey was delivered online through email invitation by the College of Emergency Nurses Australasia or the Australasian College for Emergency Medicine. A hardcopy format of the survey was also delivered at a national conference.

Results: Mental health presentations that involved a diagnosis of personality disorder, psychosis or behavioural disturbance, and the management of these conditions were patient factors that were considered problematic by up to 46.3% (118/255; 95% CI 40.26-52.40) of doctors and 66.1% (72/109; 95% CI 56.74-74.28) of nurses. Determining care plans, conducting mental status examinations, assessing risk of self-harm, pharmacology for treatment and for chemical restraint, management of patient aggression or violence, and alcohol or drug intoxication were also found to be areas of knowledge deficit.

Conclusion: Doctors and nurses reported deficits in confidence and knowledge in tasks and patient presentations that they might frequently be expected to manage. These data can be used to inform future curricula at both undergraduate and postgraduate levels. Ultimately, this might pave the way for improved care and management of patients with mental health problems presenting to the ED.