De-escalation training across crisis-response sectors: a scoping review protocol

Abstract

There is growing concern about violent or harmful encounters between crisis-intervention professionals and practitioners and individuals experiencing acute mental health crises, including those presenting with severe behavioural disturbances related to mental health concerns and/or substance use. In response, healthcare institutions and regulatory bodies are increasingly mandating "de-escalation" training. However, no universally accepted standard exists, and variability in how de-escalation trainings are defined, researched, and implemented may contribute to mixed findings regarding their effectiveness. This scoping review aims to examine the existing academic literature on de-escalation training for crisis-intervention professionals and practitioners, defined as individuals whose role — whether professional, paraprofessional, or community-based — requires them to intervene in an acute mental health or addictions crisis prior to, or during, transition to formal care. This includes, but is not limited to, paramedics, law enforcement officers, crisis intervention teams, emergency department staff, mobile crisis units, peer support workers, and others trained to intervene in crisis encounters. Eligible studies are primary research articles published in English between June 14 2014 and July 30, 2025, that report on de-escalation training in the context of a crisis encounter between a person in a mental health crisis and a crisis-intervention professional or practitioner tasked with intervening. The review will follow the five-stage framework proposed by Arksey and O’Malley (2005), with updates from Levac et al., (2010), and guided by the Joanna Briggs Institute (JBI) Framework. A medical research librarian will conduct searches in Medline, PsycInfo, Scopus, Embase, and the Education Resources Information Centre. Screening will occur in two phases: initial title and abstract review, followed by full-text review based on predefined inclusion criteria. An interprofessional team of clinicians (nursing, psychiatry), social scientists, and a police officer will perform data extraction and analysis using the PRISMA-ScR (2018) guidelines. Both qualitative and quantitative synthesis methods will be used to identify patterns and emergent themes in the literature.