Mental Dysregulation in Emergency Care, the Barriers Encountered and Competencies Needed by Professionals: A Qualitative Study
AI Summary
Emergency settings are ill suited to mental dysregulation care due to limited time, insufficient education, rigidity and poor collaboration with mental health services.
Providing care for mentally dysregulated patients causes negative personal and emotional impacts on professionals, which in turn shape interactions and care quality.
Advancement requires prioritising staff well-being and developing competencies to build productive relations within the time and organisational constraints of emergency care.
J Emerg Nurs. 2026 May 27:S0099-1767(26)00125-X. doi: 10.1016/j.jen.2026.04.015. Online ahead of print.
ABSTRACT
INTRODUCTION: Delivering suboptimal care for patients in a state of mental dysregulation is a longstanding issue in emergency care. To understand how to advance practice, this study aimed to explore the barriers encountered and competencies needed by emergency care professionals when caring for patients with acute medical conditions and mental dysregulation.
METHODS: We conducted a qualitative study, using semi-structured interviews. Seventeen emergency care professionals were purposively sampled, centering the nursing perspective. We used reflexive thematic analysis to inductively explore meaningful patterns in the data.
RESULTS: We generated 2 themes. The first, “that’s not what the setting is for,” shows why current (nursing) practice is perceived as suboptimal for addressing the needs of patients presenting with mental dysregulation; it includes a lack of time, inadequate education, rigidity, and challenging collaboration with mental health services. The second, “It affects you in a very personal way,” captures how caring for patients who experience mental dysregulation affects professionals. The mostly negative affects associated with this care may not only be the result from interactions with patients but are also perceived to shape these interactions.
DISCUSSION: Our findings deepen our understanding of the importance of professionals’ well-being and views on mental dysregulation in fostering productive relations with these patients and in providing optimal emergency care. Improvements are warranted within the practice of emergency care. To advance care, fostering the well-being of professionals is crucial, as well as building competencies that support productive relations within the constraints of emergency care.
JAMA Netw Open. 2026 May 1;9(5):e2615039. doi: 10.1001/jamanetworkopen.2026.15039.ABSTRACTIMPORTANCE: Standardized diagnostic interviews (SDIs) are structured assessments based on established criteria to improve the consistency and reliability...
J Autism Dev Disord. 2026 May 28. doi: 10.1007/s10803-026-07367-4. Online ahead of print.ABSTRACTPURPOSE: Mental health (MH) challenges in autistic youth are often under-identified due in...
J Autism Dev Disord. 2026 May 28. doi: 10.1007/s10803-026-07372-7. Online ahead of print.ABSTRACTPURPOSE: This study examined the unexplored associations between childhood adversity, maltreatment, and psychotic...
Discov Nano. 2026 May 28;21(1):223. doi: 10.1186/s11671-026-04649-9.ABSTRACTBACKGROUND: Due to the limitations of conventional cancer chemotherapy, including low bioavailability, limited indicators of therapeutic improvement, and unclear...
Neuropsychol Rev. 2026 May 28. doi: 10.1007/s11065-026-09695-9. Online ahead of print.ABSTRACTNeurofibromatosis 1 (NF1) is a rare genetic condition, frequently associated with learning difficulties. Functional neuroimaging...
JAMA Oncol. 2026 May 28. doi: 10.1001/jamaoncol.2026.1459. Online ahead of print.ABSTRACTIMPORTANCE: Patients with cancer experience significantly higher rates of suicidal self-directed violence (SSDV; defined as...
