Mental problems on the rise?
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squirrel15
Forum Captain
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I wish I could remember where I read this but it was a while ago so take this with a grain of salt.
Its not that there are more suicidal patients, but more people who are going in for help and treatment. That in today's society the stigma for asking for help in those times isn't looked at in such a bad way.
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Or maybe we should be happy that more people are getting the treatment they need?
And that mental problems might not be the best term as a healthcare provider?
perhaps not.
Uclabruin103
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Sorry, he meant to say psychiatric/behavioral problems like all the ePCRs say for primary impression.
enjoynz
Lady Enjoynz
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Not that I worked on an ambulance in years, but with the online sites I belong to, and having university age children, I'm alarmed at how many folk, especially young people, are dealing with some form of mental illness. I think pressures of modern day living, whether it be because of study, work or relationship issues, have really taken their total. People don't seem to know how to communicate one on one anymore. It is very easy to be cyber bullying with the technology we now have, and people tend to feel alone and disconnected because of it...These are just my observations....but I deal a lot with people through my YouTube channel who have some form of mental illness, whether it be depression, pain attacks,insomnia,obsessive compulsive disorder,etc,etc. There are just so many of them that it is quite sad to witness.
Clare
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Yes. A significant number of patients call for an ambulance for mental health issues.
Clinical Control will often code these as orange or green which means these patients can wait extended periods for an ambulance, sometimes several hours when it's really busy as a patient with a mental health problem and no priority symptoms is not a priority.
These patients are often not best attended to by ambulance personnel and not best served by transport to an emergency department however historically, and in many cases currently, this is the only response that can be generated. Many of these patients call out of hours meaning care information held by the GP or community based outpatient people cannot, in reality, be accessed. Many have complex psychiatric problems which I am not well trained in, many of the medicines they take I have only basic familiarity with and the extent of mental health training in the paramedic degree is basically "look out for yourself, take to ED, if need be call the police".
Speaking of the police, many of these patients are attended to by ambulance personnel in the presence of the police. The police are often not required, show up because Clinical Control or Police Comms have sent them, and while well-meaning, are often more bloody harm than they are of good. The police are not overly nice to deal with and especially not when assessing patients in the police detention suite (cells).
For patients who are acutely suicidal we can have them assessed by the community mental health nurses (CMHT) who act as Duly Authorised Officers under the Mental Health Act to determine if the patient requires inpatient referral and/or compulsory sectioning. It is advantageous that this assessment can occur in the community and while this does not require ambulance involvement although ambulance personnel are involved but are not required to treat or transport the patient. If ambulance personnel have referred the patient to CMHT, provided a competent adult can remain with the patient then the crew can leave.
What would make mental health care better for ambulance patients? Simply, and specifically;
- Secondary triage in Control with somebody who has access to their medical record
- Avoiding sending an ambulance where possible and referring to CMHT or other community-based resources
- More education for ambulance personnel
With the national rollout of the Clinical Hub and ePRF some of this should change for the better at least but I still strongly believe the system treats these patients like absolute bollocks.
Clinical Control will often code these as orange or green which means these patients can wait extended periods for an ambulance, sometimes several hours when it's really busy as a patient with a mental health problem and no priority symptoms is not a priority.
These patients are often not best attended to by ambulance personnel and not best served by transport to an emergency department however historically, and in many cases currently, this is the only response that can be generated. Many of these patients call out of hours meaning care information held by the GP or community based outpatient people cannot, in reality, be accessed. Many have complex psychiatric problems which I am not well trained in, many of the medicines they take I have only basic familiarity with and the extent of mental health training in the paramedic degree is basically "look out for yourself, take to ED, if need be call the police".
Speaking of the police, many of these patients are attended to by ambulance personnel in the presence of the police. The police are often not required, show up because Clinical Control or Police Comms have sent them, and while well-meaning, are often more bloody harm than they are of good. The police are not overly nice to deal with and especially not when assessing patients in the police detention suite (cells).
For patients who are acutely suicidal we can have them assessed by the community mental health nurses (CMHT) who act as Duly Authorised Officers under the Mental Health Act to determine if the patient requires inpatient referral and/or compulsory sectioning. It is advantageous that this assessment can occur in the community and while this does not require ambulance involvement although ambulance personnel are involved but are not required to treat or transport the patient. If ambulance personnel have referred the patient to CMHT, provided a competent adult can remain with the patient then the crew can leave.
What would make mental health care better for ambulance patients? Simply, and specifically;
- Secondary triage in Control with somebody who has access to their medical record
- Avoiding sending an ambulance where possible and referring to CMHT or other community-based resources
- More education for ambulance personnel
With the national rollout of the Clinical Hub and ePRF some of this should change for the better at least but I still strongly believe the system treats these patients like absolute bollocks.
cruiseforever
Forum Asst. Chief
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There has been a huge increase over the last few years of people being admitted to inpatient mental help. The biggest problem we have in MN is finding a place for treatment. I am thrilled when we have a transfer that is under 75 miles.
joshrunkle35
EMT-P/RN
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I spoke with my Doctor recently about this trend...his belief was that from a public health perspective, many people are getting lower quality sleep, between odd schedules, phone TV screens at night, etc., over caffeinated beverages being consumed late at night...
This loss of quality sleep leading to serotonin issues leading to psychiatric issues on a large scale.
This loss of quality sleep leading to serotonin issues leading to psychiatric issues on a large scale.
We pretty much do this. If it's a primary mental health complaint, we send a Mental Health Therapist, and a Paramedic in a SUV. They have about a 15% transport rate, the rest of the patients are deferred from the ER.
RedAirplane
Forum Asst. Chief
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My former role as a non-traditional first responder included a lot of supplemental training about mental health because of the community outreach aspect.
One in five people has a "diagnosable" mental health disorder. Stigma against mental health is decreasing (so we see more people willing to get help) but there is still plenty of stigma, and we need to be aware of it. Have you ever referred to someone as a schizophrenic? You label that person based on a medical condition they have. "He's a schizophrenic." Now think about cancer. Outside of horoscopes, does anyone say "he's a cancer?"
Aspects of modern society have been shown to affect mental function (the rise of the internet has decreased attention spans, an effect I have felt myself). However, I don't know much more about this and whether it is acutely making more people subject to conditions.
Probably not on the EMS side, but somehow we need to do a better job with mental health. Emergency room visits focus on the stabilization of any threat to self or others--the emergency. However, I don't think we do a good enough job with supportive care, preventative care, etc.
I'm not sure where I'm going with this post, so I'll conclude here.
One in five people has a "diagnosable" mental health disorder. Stigma against mental health is decreasing (so we see more people willing to get help) but there is still plenty of stigma, and we need to be aware of it. Have you ever referred to someone as a schizophrenic? You label that person based on a medical condition they have. "He's a schizophrenic." Now think about cancer. Outside of horoscopes, does anyone say "he's a cancer?"
Aspects of modern society have been shown to affect mental function (the rise of the internet has decreased attention spans, an effect I have felt myself). However, I don't know much more about this and whether it is acutely making more people subject to conditions.
Probably not on the EMS side, but somehow we need to do a better job with mental health. Emergency room visits focus on the stabilization of any threat to self or others--the emergency. However, I don't think we do a good enough job with supportive care, preventative care, etc.
I'm not sure where I'm going with this post, so I'll conclude here.