Chief Investigators: Dr Ursula Rolfe. Faculty of Health and Social Sciences. Bournemouth University, Dr Natasha Campling, School of Health Sciences, University of Southampton.

Implementation lead: Kirsty Lowery-Richardson, Head of Education, College of Paramedics

Partners: Bournemouth University, University of Southampton, College of Paramedics

CLASS Professional Publishing, Mental Health Education leads in all 11 ambulance Trusts including West Midlands Ambulance Service.

Start: 1 October 2024

End: 31 March 2026

Aim of the research:

To identify the knowledge gaps of paramedics when responding to people with mental health issues.

Background to the research:

Many people experience mental health issues in their lives and about 1 in 6 adults in England have a diagnosed common mental health illness.  Mental health issues are rising, but rates are rising most for young people.  Amongst 17- to 19-year olds rates of mental health illness rose from 10% in 2017 to 26% in 2022.

Rising rates of mental health issues combined with pressure on community services mean that that over 1.2 million people are waiting for support and treatment from NHS community mental health services.  The result of such high-level unmet demand has fallen on ambulance services and paramedics.  England’s ambulance services received 524,485 mental health related 999 calls in 2018-19, but by 2021-22 this increased to 652,720, a rise of 24%.  Across England, ambulance staff spend 1.8 million hours annually (or 75,000 days), responding to people with mental health issues. 

Paramedics express concerns attending to patients experiencing mental health issues because of a lack of education.  However, the specific nature of their knowledge gaps that underpin these concerns are not known.  Therefore, this research will identify these gaps and make recommendations to inform the future design of effective educational provision, to better support the paramedic workforce in delivering quality care for the rising population of individuals with mental health needs.

Design and methods:

The study is designed in two phases.  First, university-level education (prior to paramedic qualification) and in-practice training (once qualified) from all England’s ambulance services regarding mental health care provision will be analysed.  Second, interviews with up to 20 paramedics regarding their knowledge when managing patients with mental health issues will be undertaken.  The interviews will use patient cases, informed by real-life examples, to explore paramedic decision-making. 

Patient, public and community involvement:

We have worked with a dedicated group of individuals with lived experience of mental health issues who have received care from ambulance services and paramedics to design the study.  The group have all backed the importance of the study, highlighting the need for “more caring” by paramedics when attending those with mental health needs.  We will continue to work with this group throughout the study.  The group will help co-design study documents, such as the interview guide and patient cases for the paramedic interviews.  The group will also be given the opportunity if desired to review and input into data analysis during both study phases.

Dissemination:

Findings will be shared with healthcare commissioners, ambulance services and Universities. The project’s findings will form the basis of recommendations on educational delivery via both ambulance services and Universities, and further research on how best to provide education solutions to the knowledge gaps identified.