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Table 6 Subthemes identified for the main theme – ED Staff Experience of Training in Mental Health

From: Staff perceptions of the management of mental health presentations to the emergency department of a rural Australian hospital: qualitative study

A. Practical experience with mental health patients improves confidence

Experience I think (improves confidence in managing mental health patients), it’s taken a long while umm, years. [Nurse 8]

While I think that I have had a lot of teaching … there’s nothing like actually going in there and having the experience to deal with it. [Doctor 1]

B. Desire for more in-hospital training at this Facility

There is online stuff available…But I think more in-services for nurses particularly from mental health nurses who actually know...more stuff around the legal side of it and the different kinds of involuntary patients and maybe some stuff around doing brief mini MSEs [Mental State Examinations]. [Nurse 1]

It would be good to have just more tutorials on managing them acutely in the ED. It’s a bit different to seeing them in the acute mental health like ward when you’re doing this. [Doctor 2]

When you do it online it’s not the same as if you have someone face-to-face, give you a bit more skills and case studies and things like that that they’ve had experience with, things that we could do better. [Nurse 6]

I’ve had a lot of ED experience, I’ve been here for more than 12 years, but I still don’t feel 100% confident. I could definitely do with more training and face-to-face, online, more in-services and things like that, more up to date information. [Nurse 6]

I think face-to-face education is an enormous challenge. I always believe that face-to- face education is so much more valuable than online. [Nurse 4]

We deal with frontline, but we don’t deal with communicating with them and how to do a proper assessment, and aggression minimisation or any other techniques, calming techniques and things like that would be handy. [Nurse 6]

They’ve been trying to run violence prevention and management training for some time. The big challenge that we have with that is that quite often the dates will be released well after the time the roster’s done, so it makes it very difficult for management. [Nurse 4]

C. Lack of mental health training at this Facility

I’ve received no mental health training whatsoever from this hospital at all. [Nurse 1]

You learn it at uni, but in terms of on the job kind of refreshers and things like that, you don’t do any of it here. [Nurse 1]

We get our tutorial sessions and that’s the extent of it. [Doctor 2]

D. Barriers to further training in Mental Health

It always comes down to money and can we relieve you, can we get someone to backfill your position while you do that, that is a huge factor…if it’s not directly related to your area or your specialty, it might not be approved. [Nurse 2]

(There is) not much training in emergency mental health, so locally, obviously, and you sort of look at your circumstances outside of work and find that balance of how much time you spend away training as well. I’m not in a position to sort of go off to [city] for a week and do a course. [Nurse 2]

Online learning is a necessary evil... A couple of staff that have really struggled on farms and things that don’t have good internet, I’ve given them study leave days, allocated them an office and tried to get their study leave done online. [Nurse 4]