This paper describes a four-month preparatory training program for mental health nurses to provide an Emergency Mental Health Triage and Consultancy Service in the emergency department. The emergency department is an important gateway for patients presenting with psychiatric/psychosocial problems and mental health professionals need to provide prompt and effective care to this group of patients. Prior to the implementation of the service, it was acknowledged that occupational stress and burnout could affect the turnover of mental health nurses in the department. Therefore, a training program was employed to prepare a number of experienced mental health nurses to work at an advanced practitioner level. The four-month training program developed at Fremantle Hospital in Western Australia provided support, guidance and clinical supervision. In the first 12 months of the service, five mental health nurses completed the program, thus creating a pool of nurses who were able to provide the service. The results demonstrated that providing mental health nurses with a structured program was instrumental in facilitating their movement to an advanced practitioner level. The nurses were able to apply advanced knowledge and skills to assess and manage clients with complex mental health /psychosocial problems. Furthermore, on leaving the emergency department these nurses were able to utilise the advanced skills in other areas of mental health nursing practice.