Interventions to reduce interpersonal stigma towards patients with a mental dysregulation for ambulance and emergency department healthcare professionals: review protocol for an integrative review

Abstract

IntroductionWorldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department care. The care of patients with a mental dysregulation (ie, experiencing a mental health problem and disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours) can be complex and challenging in the emergency care context, possibly evoking a wide variety of feelings, ranging from worry or pity to annoyance and frustration in emergency care staff members. This in return may lead to stigma towards patients with a mental dysregulation seeking emergency care. Interventions have been developed impacting attitude and behaviour and minimising stigma held by healthcare professionals. However, these interventions are not explicitly aimed at the emergency care context nor do these represent perspectives of healthcare professionals working within this context. Therefore, the aim of the proposed review is to gain insight into interventions targeting healthcare professionals, which minimise stigma including beliefs, attitudes and behaviour towards patients with a mental dysregulation within the emergency care context.Methods and analysisThe protocol for a systematic integrative review is presented, using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A systematic search was performed on 13 July 2023. Study selection and data extraction will be performed by two independent reviewers. In each step, an expert with lived experience will comment on process and results. Software applications RefWorks-ProQuest, Rayyan and ATLAS.ti will be used to enhance the quality of the review and transparency of process and results.Ethics and disseminationNo ethical approval or safety considerations are required for this review. The proposed review will be submitted to a relevant international journal. Results will be presented at relevant medical scientific conferences.PROSPERO registration numberCRD42023390664 (https://www.crd.york.ac.uk/prospero/).

Invited editorial: A guide to caring for patients who identify as transgender and gender diverse in the emergency department: The evolution of evidence‐based medicine

“…Examples of evolving practice improvements that directly benefitted patient care outcomes include utilization of ultrasonography for central lines, 4 opioid prescribing practices, 5 cardiac life support, 6 and overcrowding. 7 Emergency department care for other populations (those with HIV, 8 substance use disorder, 9 or mental health 10 ), which have historically been stigmatized and marginalized while in our care, has improved with education and research, and optimally these conversations can continue to progress.…”