Abstract
Ambulance services have had to shift their traditional approach of treating and transporting patients to adapt to consumer demands. While there has been a significant and sustained expansion in evidence-informed clinical practice guidelines for physical health presentations, the same cannot be said for mental health presentations. The current evidence base has predominantly focused on involuntary patients, which has created a gap in the understanding of most mental health patients treated by paramedics.This study’s aim was to articulate the lived experience of paramedics who were providing care to mentally unwell individuals in the community. In detailing these authentic experiences, I sought to understand paramedics’ challenges, perspectives and insights in delivering care to mental health consumers.
This study employed a descriptive phenomenological approach to capture in-depth, detailed descriptions of the phenomenon under investigation. Eighteen Australian paramedics employed by jurisdictional ambulance services participated in the study. The unstructured recorded interviews that were conducted with each paramedic were between 25 to 95 minutes. Data was analysed using Colaizzi’s seven-step phenomenological approach.
The data analysis produced four central themes: (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. The study revealed that the process of delivering care is a multifaceted phenomenon that has been influenced by a variety of factors that has included structural and non-structural barriers. These barriers are either personal, professional and/or organisational in origin and have played a role in shaping the delivery of care.
The study’s findings have shed light on paramedics’ interactions with mentally unwell individuals. The paramedics who participated in this study expressed their limitations in adequately addressing the needs stemming from various mental health conditions and attributed this deficiency to insufficient education, training and on-site support. They found themselves becoming increasingly frustrated with a system that prioritises episodic care at the expense of a comprehensive and holistic approach. Furthermore, the limited availability of specialised services and referral networks is adding to the complexities paramedics are facing in endeavouring to deliver optimal care to mentally unwell persons.
| Date of Award | 2024 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Supervisor | Paul Simpson (Supervisor) |