Overcoming Stigma of Mental Illness in Paramedicine – A Model for Future Practice
PDF

Keywords

paramedicine
mental illness
stigma
symbolic interactionism
enculturation

How to Cite

1.
Brewster L, Bear R, Maria S. Overcoming Stigma of Mental Illness in Paramedicine – A Model for Future Practice. Australasian Journal of Paramedicine [Internet]. 2022Oct.30 [cited 2023Mar.26];19. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/1023

Abstract

Introduction

Mental health presentations are a rapidly growing proportion of cases seen by paramedics who are often at the frontline of care delivery. How paramedics perceive persons with mental illness is vital as their experiences in providing care can significantly impact decision-making. This article aims to investigate these paramedics' experiences and how these influence patient care.

Methods

This qualitative research study uses a narrative design where the researchers conducted two focus groups with operational paramedics (six paramedics), and the data recorded and transcribed. The team closely examined the data using thematic analysis to identify, analyse, and interpret patterns of meaning within transcribed data. After thematic analysis, a model for future practice was generated, which pictorially demonstrates the overlap of the common themes.

Results

Five themes ultimately were identified that profoundly appeared to be important to the paramedics within the focus groups. Paramedics have varying experiences when caring for people with mental illness. They are empathetic towards the circumstances of the person with mental illness. They perceive that the stigmatisation of persons with mental illness occurs in some cases. Paramedics are also affected in their clinical decision-making by the training and education they have received and the profession's cultural influences.

Conclusion

The stigmatisation of people with mental illness is apparent in paramedic practice. Despite mental illness being a common presenting problem, paramedics feel underprepared and have difficulty in treating these people. The patients' behaviour can often be reflected in the conduct of paramedics. The impact of burnout due to high exposure to people with mental illness, especially in metropolitan areas, may lead to decreased levels of empathy and compassion.

https://doi.org/10.33151/ajp.19.1023
PDF

References

Mildenhall J. Occupational stress, paramedic informal coping strategies: a review of the literature. JPP. 2012;4(6):318-28.

Smith R, Parent A, Townsend R, Johnston T. Mental health education in Australian paramedic curricula–A scoping review. Australas J Paramedicine. 2020;17.

Roberts L, Henderson J. Paramedic perceptions of their role, education, training and working relationships when attending cases of mental illness. Australas J Paramedicine. 2009;7(3).

Pescosolido BA, Martin JK, Lang A, Olafsdottir S. Rethinking theoretical approaches to stigma: A framework integrating normative influences on stigma (FINIS). Soc Sci Med. 2008;67(3):431-40.

Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ. Stigmatisation of people with mental illnesses. Br J Psychiatry. 2000;177(1):4-7.

Hugo M. Mental health professionals’ attitudes towards people who have experienced a mental health disorder. J Psychiatr Ment Health Nurs. 2001;8(5):419-25.

Rao H, Mahadevappa H, Pillay P, Sessay M, Abraham A, Luty J. A study of stigmatized attitudes towards people with mental health problems among health professionals. J Psychiatr Ment Health Nurs. 2009;16(3):279-84.

Schulze B, Angermeyer MC. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med. 2003;56(2):299-312.

Rees N, Rapport F, Snooks H. Perceptions of paramedics and emergency staff about the care they provide to people who self-harm: Constructivist metasynthesis of the qualitative literature. J Psychosom Res. 2015;78(6):529-35.

Rees N, Rapport F, Snooks H, John A, Patel C. How do emergency ambulance paramedics view the care they provide to people who self harm?: Ways and means. Int J Law Psychiatry. 2016.

Rees N, Rapport F, Thomas G, John A, Snooks H. Perceptions of paramedic and emergency care workers of those who self harm: A systematic review of the quantitative literature. J Psychosom Res. 2014;77(6):449-56.

Roe J, Joseph S, Middleton H. Symbolic interaction: A theoretical approach to understanding stigma and recovery. Ment Health Rev J. 2010;15(1):29-36.

Blumer H. Symbolic interactionism: Perspective and method: New Jersey : Prentice-Hall Inc: 1969.

Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5(1):80-92.

Knaak S, Mantler E, Szeto A, editors. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare management forum; 2017: SAGE Publications Sage CA: Los Angeles, CA.

Miriam Webster. Online 2021. Enculturation.

van der Gaag A, Donaghy J. Paramedics and professionalism: looking back and looking forwards. JPP. 2013;5(1):8-10.

Hou XY, Rego J, Service M. Paramedic education opportunities and challenges in Australia. Emerg Med Australas. 2013;25(2):114-9.

O’Sullivan B. Paramedic attitudes to deliberate self-harming behaviour in Ireland. JPP. 2014;6(3):116-8.

Prener C, Lincoln AK. Emergency medical services and “psych calls”: Examining the work of urban EMS providers. Am J Orthopsychiatry. 2015;85(6):612.

McCann TV, Savic M, Ferguson N, Bosley E, Smith K, Roberts L, et al. 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. PLoS One. 2018;13(12):e0208391.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2022 Array