Paramedics’ clinical judgment and mental health assessments in emergency contexts: Research, practice, and tools of the trade

Abstract

Mental health and illness are global health priorities. International reforms of mental health care systems repeatedly call for increased participation of a wide range of health, welfare, and disability professionals and organisations in providing services to people with mental disorders. There are increasing needs to improve mental health skills of all health-care professionals, improve coordination of services provided to consumers of mental health services and their and carers, and foster greater community interest and involvement in mental health issues. Despite this, the roles of paramedics and contributions they can make to the care of the mentally ill in the wider continuum of health care have not been fully recognised. Traditionally, the work of paramedics has been limited to managing specific conditions such as suicide. The reasons for this are many and varied, but one consequence of it is that research into paramedic judgment and decision-making of mental illness is rare. This paper will present a review of key research examining mental health assessments in the emergency care context, with a specific focus on paramedics. It will examine the use of mental assessment tools or instruments by ambulance and emergency medical personnel and highlight the needs for future research into this important area of health-care. Central to global mental health reforms is the preparedness of health care professionals, including paramedics, to recognise, assess, and manage mental illness in everyday practice and the sufficiency of education and training programs, clinical standards, policy, and legislation to ensure quality and accountability in the care of the mentally ill.