Abstract
Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.
Highlights
The prevalence of mental illness is substantial, with 29.2% of adults experiencing mental illness in their lifetime [1]
Female paramedics were significantly younger and had higher qualifications with more graduate degrees, but they were less experienced than males and more likely to work in general care as compared to more management and intensive care roles in males (p < 0.001 in all) (Table 1)
Regional differences were observed with age increasing (p < 0.001) and level of qualification decreasing (p = 0.003) comparing metropolitan to regional or rural and remote locations
Summary
The prevalence of mental illness is substantial, with 29.2% of adults experiencing mental illness in their lifetime [1]. In Australia, almost 45% of the population aged 16–85 years has experienced mental illness at some point in their life [2]. National data from 2015 reveal that mental and substance use disorders were the second largest contributor of non-fatal disease burden in Australia at 24%, behind musculoskeletal conditions at 25% [4]. Despite this relatively high prevalence, many people do not access services for treatment due to various structural barriers, such as availability
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