Paramedic perceptions of their role, education, training and working relationships when attending cases of mental illness.

Abstract

<jats:p>Introduction This study explores the perceptions of paramedics regarding their role, education and training, organisational culture and interaction with allied professionals when attending suspected or known cases of mental illness. The study uses the South Australian Ambulance Service (SAAS) clinical data to establish a quantitative measure of workload in relation to cases that have been classified as psychiatric. It examines how paramedics perceive their use of the resources currently in place to support practice and their role when dealing with patients displaying mental illness. Methods Data were sourced from the SAAS clinical database, a survey and three focus groups. One hundred and fifty surveys were distributed to career paramedic staff in both metropolitan and regional centres of South Australia with a response rate of 49.3% (n=74). The survey was analysed using descriptive statistics to compare paramedics‟ perceptions of workload and time-on-scene with the quantitative data from the SAAS Clinical Database. Thematic analysis was undertaken of the open questions from the survey and focus groups data. Results The analysis of workload and time-on-scene showed significant differences between the SAAS database and paramedic perceptions. The survey and focus groups discussed themes in relation to paramedic practice: the role of paramedics in managing mental illness, education and training, organisational culture and interdisciplinary relationships. Conclusion Mentally ill patients comprise a growing proportion of the workload of paramedics. This descriptive and exploratory study identifies issues in relation to their perception of workload, education and training, organisational culture and their working relationships with other services. Further research is recommended to understand how these perceptions affect paramedic practice in this area.</jats:p>

Perceptions of paramedics and emergency staff about the care they provide to people who self-harm: Constructivist metasynthesis of the qualitative literature

“…In contrast, Roberts and Henderson [28] conducted a study of the perceptions of paramedics regarding their role, educational training and organisational culture when attending suspected or known cases of mental illness. One participant paramedic noted, I was criticised for being a social worker because I would actually sit down and talk to them.…”

“…Roberts and Henderson [28] acknowledge that although the police no longer routinely attend in mental illness cases in Australia, paramedics still call for their support in difficult cases. Luck and Towsend [37] reported a case in Australia which highlights challenges the police also face in dealing with self-harm.…”

“…All of the studies surrounding paramedic management of mental health emergencies are from Australia [28,30,[38][39][40]; however, there are significant differences in paramedic education and legislation. Despite this, there is similar detail of confusion revealed by paramedics in Shaban [30]:…”

“…Paramedics identified attending to life-threatening conditions their first priority, dealing with the consequences of behaviour such as managing an overdose or physical trauma, underlying mental illness was felt to be outside their skill level, as illustrated in the paramedic quotes in Roberts and Henderson [28]:…”

“…Roberts and Henderson [28] argued that limited training, time constraints, 'frequent flyers' and a perception of limited treatment options influences the value placed on treatment of mentally ill patients. Paramedics felt that they were 'filling in the gaps' in providing services for people that an under-resourced and under-funded mental health system struggle to provide.…”