Behavioral Health Emergencies Encountered by Community Paramedics: Lessons from the Field and Opportunities for Skills Advancement

Keefe, Bronwyn; Carolan, Kelsi; Wint, Amy J.; Goudreau, Matthew; Cluett, W. Scott; Iezzoni, Lisa I.

doi:10.1007/s11414-020-09687-4

Cited by 12 publications

(15 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mental health crises will often take place in a person’s home with others, often family, present. In line with research of parents of children with psychosis,87 companions described the, often traumatic, impact of the FR response and a lack of inclusion and communication 18 24–30 33–37 39–41 43–60 62–70 74–78 81 82 86 88–104. Our findings reflect that of previous studies,105 which show that family/carers experience distress, guilt, reluctance to call FRs, fear of disproportionate use of force and relief for having FR support.…”

Section: Discussionsupporting

confidence: 89%

“…Previous reviews71–73 reported FRs’ reasons for force, such as their duty of care, bystanders and themselves, and that PMI are likely to be resistant and this would require proportionate force. FRs suggested that using force is required to gain control and central to their profession, and dealing with MHC was not, at least officially, a central part of their role 25 26 33 36 37 45 51 52 56 58 59 62 68 70 74–78. However, the role of FRs in managing mental ill health in the community is vital and likely to increase due the COVID-19 pandemic,79 the subsequent economic crisis, as well as climate change, which disproportionally affects vulnerable people and can be the cause for mental illness 80.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

2022

View full text Add to dashboard Cite

ObjectiveTo review and synthesise qualitative studies that have explored subjective experiences of people with lived experience of mental health-related illness/crisis (MHC), their families and first responders.DesignA systematic review of qualitative evidence was conducted. English-language articles exploring the content of interactions and participants’ experiences were included.Data sourcesMEDLINE, PsycINFO, EMBASE, CINAHL; Google Scholar, SAGE journals, Science Direct and PubMed.Data extraction and synthesisTwo reviewers read and systematically extracted data from the included papers. Papers were appraised for methodological rigour using the Critical Appraisal Skills Programme Qualitative Checklist. Data were thematically analysed.ResultsWe identified 3483 unique records, 404 full-texts were assessed against the inclusion criteria and 79 studies were included in the qualitative synthesis. First responders (FRs) identified in studies were police and ambulance staff. Main factors influencing response are persistent stigmatised attitudes among FRs, arbitrary training and the triadic interactions between FRs, people with mental illness and third parties present at the crisis. In addition, FR personal experience of mental illness and focused training can help create a more empathetic response, however lack of resources in mental health services continues to be a barrier where ‘frequent attenders’ are repeatedly let down by mental health services.ConclusionLack of resources in mental healthcare and rise in mental illness suggest that FR response to MHC is inevitable. Inconsistent training, complexity of procedures and persistent stigmatisation make this a very challenging task. Improving communication with family carers and colleagues could make a difference. Broader issues of legitimacy and procedural barriers should be considered in order to reduce criminalisation and ensure an empathetic response.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

2022

View full text Add to dashboard Cite

show abstract

“…All studies (Evans et al, 2014 ; Ford‐Jones & Daly, 2020 ; Keefe et al, 2020 ; Leyenaar, Allana, et al, 2021 ; Leyenaar, McLeod, et al, 2019 ; Stirling et al, 2007 ; Xi et al, 2021 ) outlined the importance for community paramedics to be able to undertake a general health assessment. Eight years ago, Evans et al ( 2014 ), found that a general health assessment was among one of the most common roles reported in their literature review, with an emphasis on acute minor conditions, rather than complex multi‐organ disease.…”

Section: Resultsmentioning

confidence: 99%

“…Across the literature reviewed, there was no clear standardisation regarding what an expanded scope of role for community paramedics would include, especially since practice guidelines were still being established as paramedics move to work in these relatively new clinical areas(Eaton, Wong, et al, 2021;Leyenaar, Allana, et al, 2021). However, three key components that were considered to be a staple requirement of the scope of the role expected of a community paramedic where general health assessment, psychosocial assessment and health promotion.3.7.1 | General health assessmentAll studies(Evans et al, 2014;Ford-Jones & Daly, 2020;Keefe et al, 2020;Leyenaar, Allana, et al, 2021;Leyenaar, McLeod, et al, 2019;Stirling et al, 2007;Xi et al, 2021) outlined the importance for community paramedics to be able to undertake a general health assessment. Eight years ago,Evans et al (…”

mentioning

confidence: 99%

The development of community paramedicine; a restricted review

Shannon

Eaton

Lanos³

et al. 2022

Health Social Care Comm

View full text Add to dashboard Cite

Community paramedic roles are expanding internationally, and no review of the literature could be found to guide services in the formation of community paramedicine programmes. For this reason, the aim of this restricted review was to explore and better understand the successes and learnings of community paramedic programmes across five domains being; education requirements, models of delivery, clinical governance and supervision, scope of roles and outcomes. This restricted review was conducted by searching four databases (CENTRAL, ERIC, EMBASE, MEDLINE and Google Scholar) as well as grey literature search from 2001 until 28/12/2021. After screening, 98 articles were included in the narrative synthesis. Most studies were from

show abstract

“…We know that early interventions are imperative and a number of the articles in this issue concentrate on youth, focusing on ways pediatric behavioral health services might intervene to reduce non-urgent emergency departments visits (in the Keefe et al paper), 1 developing training and technical assistance centers that respond to the special needs of youth with serious emotional disorders (in the Olson et al paper), 2 and assessing the mental health practices that have led to youth "aging out" of the system at 18 years (in the Cohen et al paper). 3 Additionally, we focus on the importance of diversity by highlighting the nature of mental health needs among an emerging Latino community with limited health care information (in the Bucay-Harari et al paper) 4 and examining how telepsychiatry might reduce treatment gaps in LGBT communities (in the Whaibeh et al paper).…”

mentioning

confidence: 99%

Our Voice and Our Vote Are More Important Than Ever Before

Ingoglia

2020

J Behav Health Serv Res

View full text Add to dashboard Cite

The COVID-19 pandemic has made it clear how vital behavioral health professionals are to our individual health and to the health of our communities. More than ever, behavioral health professionals provide clients with life-saving treatment and services. It is truly hard to imagine where we would be as a nation without care from behavioral health professionals. The need will only intensify in the weeks and months ahead as we face a long period of recovery of our health, spirit, and economy, addressing the inevitable toll of long-term trauma on the nation's mental health.For many of us, the future is uncertain. Clinics providing needed services to some of our nation's most vulnerable, those living with mental illness and addictions and their families, are struggling to keep their doors open. The victims of these closures will not only be their patients and clients, they will be the staff who have bravely put their own fears aside to provide comfort and treatment.While the future is unclear and the full extent of the health crisis is still unfolding, I see promising signs of hope. The behavioral health field has always embodied strength and resilience, and that is certainly true right now.Even in these dark times, I have seen the power of unity and what can happen when we speak with one voice to let our nation's leaders know our wide-ranging contributions and our great needs. The National Council has joined our voices with organizations, policymakers, and individuals within our own community. Our list of victories is inspiring, and it is all because we recognize that we are better together.Our strength was evident as we spoke up to Congress and they listened. We secured policy changes supporting our community, gaining latitude in the use of telehealth and expansion of audio-only telehealth and Medicare coverage for a wider range of providers of telehealth services. Such efforts included Medicaid nonprofits in the Paycheck Protection Program and temporary relief of the Ryan Haight Act which allowed greater flexibility to prescribe controlled substances like antipsychotics and medication-assisted treatment (MAT), among others. In addition, the National Council spearheaded the largest mental health and addiction advocacy request in history, leading the effort for 40 other advocacy organizations to sign a request totaling $38.5 billion for behavioral health providers.However, we still have far to go. As the nation continues to grapple with and recover from COVID-19 and its aftershocks, we need continued investment in behavioral health. There are

show abstract

Behavioral Health Emergencies Encountered by Community Paramedics: Lessons from the Field and Opportunities for Skills Advancement

Cited by 12 publications

References 15 publications

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

The development of community paramedicine; a restricted review

Our Voice and Our Vote Are More Important Than Ever Before

Contact Info

Product

Resources

About