Protected Engagement Time and Related Interventions: A Scoping Review of Experience and Outcomes, and Relevance to the Australian Context.

Engagement between mental health nurses (MHNs) and older adults on acute mental health units is often hindered by age-related factors such as cognitive decline, frailty and sensory impairment, as well as psychosocial challenges including bereavement, social isolation and loss of identity. This makes therapeutic engagement essential on older adult mental health units. However, high workloads, administrative demands and the dominance of risk management often limit meaningful interactions. Protected engagement time (PET), originally introduced in the United Kingdom, was designed to preserve dedicated, interruption-free time for MHNs to engage therapeutically with consumers. This scoping review aimed to map existing literature on PET and to examine its relevance to the Australian older adult acute mental health context. The review was conducted in accordance with the Joanna Briggs Institute methodology and reported using the PRISMA-ScR checklist. After screening, eight studies met the inclusion criteria, with none conducted in Australia, and only two focused specifically on older adult units. Data analysis revealed four overarching categories: relational engagement and therapeutic presence, individualised and meaningful engagement, staffing and organisational structure, and outcomes and broader impacts. This scoping review suggests that PET can positively influence engagement between mental health consumers and MHNs, with benefits extending beyond the sessions themselves. However, the review highlights the need to evaluate how this approach may be integrated in older adult mental health units to enhance the therapeutic relationships, promote recovery and uphold dignity to some of the most vulnerable consumers in mental health care.