Paramedics’ Confidence and Perceived Competence When Attending to Varied Patient Presentations: A Mixed-Method Study

Abstract

Purpose: Paramedics are routinely called to patients presenting with mental health concerns. Previous literature suggests paramedics find this patient group challenging. However, no study has investigated whether paramedics find mental health presentations (MHP) more challenging relative to other patient presentations, or whether certain paramedic variables relate to their perceived ability to manage MHP. This study investigates differences in paramedics’ perceived ability to attend to MHP compared to other patient presentations, and whether their perceived ability is related to their level of experience or location of work (metropolitan or rural). The study also explores paramedic’s experiences and perspectives of MHP. Method: Operational paramedics in Australia (n = 138) completed a survey assessing their perceived ability to respond to mental health, cardiac, respiratory, and trauma-related presentations. A repeated measures ANOVA tested differences in perceived ability between these patient presentations. T-tests and Pearson’s correlations were conducted to determine whether years of experience or location of work related to their perceived ability for MHP. Nine paramedics were also interviewed, and a thematic analysis conducted to gain insight into paramedic’s experiences and perspectives of MHP. Results: Paramedics reported a significantly lower perceived ability to respond to MHP relative to each other patient presentation measured. No relationships were found between a paramedic’s perceived ability to respond to MHP and their length of work experience or location of work. Interviews with paramedics revealed four superordinate themes: 1) inconsistent conceptualization of their role, 2) feelings of helplessness and frustration, 3) stigmatized views of patients with a mental illness, and 4) inconsistent views of knowledge and learning relating to MHP. Conclusions: Paramedics believe they have a significantly poorer ability to respond to MHP relative to other patient presentations. Education and training focused on defining a paramedic’s role for MHP as well as reducing stigmatized views of patients with a mental illness may improve paramedic’s care of this cohort of patients.