title: Which skills boost service provider confidence when managing people presenting with psychiatric emergencies?
abstract: The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints.
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Daniel
authors.initials: D
authors.lastname: Poremski
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Xin Ya
authors.initials: XY
authors.lastname: Lim
authors.affiliation: Institute of Mental Health, Singapore.|Yong Loo Lin School of Medicine, The National University of Singapore.|Duke Graduate Medical School, The National University of Singapore.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Kunjithapatham
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Doris
authors.initials: D
authors.lastname: Koh
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Mark
authors.initials: M
authors.lastname: Alexander
authors.affiliation: Institute of Mental Health, Singapore.|Yong Loo Lin School of Medicine, The National University of Singapore.
authors.forename: Lee
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000208:Acute Disease; D002983:Clinical Competence; D003142:Communication; D004630:Emergencies / Q000523:psychology; D004636:Emergency Service, Hospital; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017008:Negotiating / Q000523:psychology; D012944:Social Support
keywords: Emergency psychiatric services; Non-technical skills; Staff confidence