Exploring the lived experience of paramedics responding to individuals experiencing a mental health crisis in the community: a phenomenological study

Aim: This phenomenological study explored the lived experience of paramedics attending to individuals experiencing a mental health crisis in the community. Background: In recent years, paramedicine has evolved significantly, becoming a distinct discipline within the health sector with transformed roles and practices. Simultaneously, mental healthcare has transitioned for most consumers to community-based models of care. However, limited services have led individuals to rely on emergency departments and ambulance services as their primary, albeit last resort, during a crisis. Consequently, paramedics have become crucial providers of unscheduled mental healthcare, offering assessment and support to individuals experiencing a mental health crisis. Method: This study utilised descriptive phenomenology, following the tradition of Husserl, to capture detailed descriptions of the phenomenon under study. Eighteen Australian paramedics employed by a Jurisdictional Ambulance Services took part in the study. Unstructured recorded interviews were conducted with each participant, ranging from 25 to 95 min. Data analysis was carried out using Colaizzi's seven-step method. Results: The study revealed four central themes experienced by paramedics: (a) the clinical interaction; (b) the barriers to accessing care for mental health consumers in a one-size-fits-all system; (c) It's just all a little bit grey – paramedic education and training in mental health presentations; and (d) the paramedic, the clinician and the person. Structural and non-structural barriers, including personal, professional and organisational factors influenced care delivery. Limited specialised services and referral networks further complicate optimal care delivery. Conclusion: The study highlights paramedics’ challenges in caring for individuals experiencing a mental health crisis. Participants noted their limitations due to inadequate education, training and on-site support, leading to frustration with a system focused on episodic rather than holistic care. Additionally, limited access to specialised services and referral networks complicated their efforts to provide optimal care.