References
Paramedic management of patients with mental health issues: a scoping review
Abstract
Background:
Since the COVID-19 pandemic and the introduction of the
Aims:
To identify and examine current research on how paramedics manage people with mental health issues.
Methods:
A scoping review was carried out using the five stages of Arksey and O'Malley's framework. A research question—’How do paramedics manage patients with mental health issues?’—was developed, databases searched, studies identified and data charted, summarised and reported.
Findings:
Fifteen papers were included, and five themes identified: perceptions and expectations; call triage and inter-service collaboration; communication skills; lack of education and training; and assessment and evidence-based interventions.
Conclusions:
There is global evidence of the deficiencies in paramedic education around mental health presentation and a need for evidence-based education and interventions to improve patient outcomes.
Paramedics spend about 1.8 million hours per year (the equivalent of 75 000 days) managing patients with mental health issues (National Institute for Health and Care Research Applied Research Collaboration East Midlands (NIHR ARCEM, 2024). England's ambulance services received 524 485 999 calls in 2018--2019, which increased to 652 720 in 2021-2022—a rise of 24% (NIHR ARCEM, 2024). The National Audit Office (2023) reported in February last year that 1.2 million people were waiting to receive care and treatment from NHS community mental health services.
Before the Covid-19 pandemic, rates of mental illness in England were steadily rising, according to the British Medical Association (BMA, 2024). The prevalence of common mental health disorders (such as anxiety or depression) among adults aged 16-64 years had increased from 17.5% in 2000 to 18.9% in 2014. The BMA (2024) added that Covid-19 accelerated this trend, generating an increase in the number of people who are in contact with secondary mental health services. Mental health services in England received a record 4.6 million referrals during 2022 (up 22% from 2019). Nearly half (43.4%) of adults (24.5 million in England) think they have had a diagnosable mental health condition at some point in their life (NHS Digital, 2016), with prevalence of depression increasing during pandemic years (Office for National Statistics, 2021).
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