Emergency medical services and “psych calls”: Examining the work of urban EMS providers.

Abstract

Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs. (PsycINFO Database Record

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

“…Overall, our findings reiterate broader calls for improving the quality of ambulance care for people presenting with mental health and/or AOD issues . A range of measures could be included to achieve this, including an educational approach to address potential skills gaps around communication.…”

“…Australian studies have shown that between 10% and 20% of ambulance presentations are related to mental health and/or AOD concerns . Similar to stigmatizing attitudes documented in the general population and amongst some health professional groups, research indicates that some paramedics display negative attitudes towards people who present with mental health and/or AOD problems . Such negative attitudes may act as a barrier to help‐seeking and recovery in this population …”

“…Ambulance services are a key front‐line emergency service, attending over 1.3 million emergency incidents annually, of which many are likely to include men with mental health and/or AOD issues . Indeed, paramedics report that attending mental health and/or AOD presentations comprises a significant proportion of their workload . Australian studies have shown that between 10% and 20% of ambulance presentations are related to mental health and/or AOD concerns .…”

Paramedics’ perceptions of their scope of practice in caring for patients with non-medical emergency-related mental health and/or alcohol and other drug problems: A qualitative study

“…A qualitative study (observations and interviews) by Prener and Lincoln [2] in the US found that urban paramedics and emergency medical technicians were frustrated by what they perceived as “filling the gaps for other health care and social services” in attending to patients with mental health and/or AOD problems. Similarly, studies have documented a perception amongst paramedics that non-medical emergency-related mental health and/or AOD presentations divert resources and attention away from the ‘real’ medical emergency work that paramedics believe should be the primary focus of their work [2, 6].…”

Driving to Work: The Front Seat Work of Paramedics to and from the Scene

“…Furthermore, while an overview of the sociology of work is outside the scope of this article (see, e.g., Abbott ; Gorman and Sandefur ), a major theme within this literature is on the “nature of the work process” (Tope et al :476). The work of paramedics discussed above, and the analysis undertaken below, contribute to the sociological study of work and occupations by first and foremost shedding light on an ever‐important occupational group in health care that has garnered little sociological attention until recently (see, e.g., Prener and Lincoln ; Seim ). In addition, my explicit focus on the hidden and taken‐for‐granted work of paramedics aligns with new directions in research on work and occupations that call for a shift in focus “away from the individual to the conditions and relations of work” (Armstrong 2013:101).…”