Mental health

[Kiwiology]

So I was listening to somebody have a moan and bitch at me about having to "waste his time" dealing with some "bullshit nutter" when there was "nothing wrong with her" and "the cops didn't want to take her to the cop shop so they called us"

This is not the first time I have heard similar things said around the ambulance station from some very experienced, and by all accounts very empathetic and caring Paramedics. There is only a small amount on mental health in the National Diploma modules and nothing in the old Paramedic (ICO) modules I have completed, I haven't done the Degree so I can't speak for what they get taught.

It really pisses me off that we are quick to judge somebody as being a "nutter" or "attention seeker" or "fucked in the head" and write them off as bullshit because "hey, I could be sleeping right now!" yet I don't Ananybody writing off Nana who has fallen over and needs picking up, dusting off and putting back in bed or some bloke with chest pain as "some attention seeking bullshit job taking away my sleeping time!".

Mental health is a significant burden upon self and society; I would argue somebody with a mental health problem is at a greater risk of injury, illness and premature death than somebody who has advanced cardiovascular disease or who is obese. The WHO estimate 400 million people worldwide suffer from a mental health disorder, that a half million people per year commit suicide and that by 2020 depression will top trauma, stroke and ischaemic heart disease to become the second leading cause of death.

Why is it that we are quick to point the finger at people who have a psychological or psychiatric or other "mental health" problem as being somehow less deserving of Ambulance skills and resources or somehow less unwell or hoemostatically imbalanced than somebody who is has a fractured femur, cardiac chest pain or the sniffles?

But that is not important right, because they are just "some bullshit nutter seeking attention?"

Now with that thoughtt of the way for the evening, its a perfect time for me to go get destroyed on valiums and uppers to quell the intense psychoemotional agony I deal with on a daily basis

What, like that makes me biased or something? Mmmm valiums

[Arctickat]

You're such a nutter. Have the aliens been telling you to do things again?

I used to have little patience for mental health issues, mainly because I couldn't understand the complexities behind the disease. Over time I learned though, and I've come to understand that a mental health crisis is just as significant as any other medical emergency.

[Vorenus]

Guess the attitude comes from the fact, that you can`t do much for these patients. It`s not like that "fancy" medicine, working meds and doing big procedures. Sure in a suicide, you may get to really do something (though in your usual attempt, not even than that much - and the most primarily succesfull attempts, you`re usually not in a position to get to do much, at least in my experience) and you could use chemical restraint in a violent or agitated person.

But with your "normal" mental patient, that poses no danger to oneself or his surrounding and just has a chronical condition - it`s mostly just observational taxi-driving, so maybe there`s a tendency to place this calls down.

[Kaisu]

The thing to remember is that no-one raises their hand and says "yes please - I'll have the schizophrenia and while you're at it throw in some addiction issues too." These people, through no fault of their own, are ill and need help. They call us because we are what there is when people need help with health problems, including mental health problems.

If you are fortunate to live in a part of the country with good mental health services, than at the very least, you serve as an entry point into the system. At the other end of the scale is saving a life - someone for whom the pressures to commit suicide outweighed the resources to overcome the pressures.

Nobody that aspires to be a health care professional gets off with the excuse "they didn't teach us that in school." If you are running on these patients, than you have an obligation to educate yourself so that you can be of help to them. It's your job.

[island emt]

What Kaisu said!

In todays world where the funding for inpatient mental health facilities, & outpatient services had been drastically cut due to funding slashes, we have to respond and deal with these patients all too often. We are the last resort for many of these folks and need to understand the complexities of mental heath issues.

We are their advocates and the gatekeeper for the services they desperately need.

[firemedic37]

This is becoming an all too common theme at work for us. As previously mentioned people don't get to pick and choose wether they have it or not. I have to remind myself daily that these individuals are the same as the rest of our patients; they are asking for our help in their time of need. Is that not what we got into EMS for, is to be able to help people when they need it the most?

For most of these people their families are tired of dealing with it so they stop giving them any type of support. A lot of time these people just need someone to listen to them. I have taken my fair share of behavioral patients across the state. Yes we may not be able to practice our skills like a good trauma allows us to, but it allows us to get back to what all humans need. They need to feel as they are needed and worth living, focus on the positives in the patients life. Yes, it may be hard if we don't know much about the patient but we need to strive to get to know our patient so we are better able to help them.

A simple conversation with these people can make a huge difference, I have seen it first hand. I have had behavioral health patient return and thank me for just listening to them and offering them words of encouragement. No I didn't preach the gospels to them, I simply talked to them as a human and treated them with respect.

EMS has a bad reputation for treating behavioral patients as a burden and not as a patient. Remember back in class we could not wait to get on the rig? Well this is part of our job and we should be just as willing to care for a behavioral patient as a trauma or cardiac patient.

[DFIB]

Kaisu!!!!

I love the way you think girl! I think that the issue also speaks to our professional attitudes, I am an EMT (soon to be medic, keep your fingers crossed for me) because I enjoy helping sick people, no matter what their infirmity may be. A "nutter" is in as much pain or more than a trauma patient, only we cant splint a broken heart or mind. In trauma patient we rarely really save any lives but with mental patients our kind evaluation, attitudes and words could indeed be a life changer, or even a life saver.

When I work I am there for whatever the shift may bring. Any medic that does not want to help people who are mentally ill should reevaluate the reasons that they are a medic.

[emtdennis]

I think some of the issue of helping mentally challenged people is that you can't "see" the problem and it is hard to help. A physical problem, (broken leg, cardiac issues) you can see and deal with.

I have seen situations where we may get called out for a "frequent flier" that does have mental issues. It gets frustrating where it is a case of the person not taking their meds (but you can not reason with them). We were getting called out for a gentleman a couple of times a week during the winter and ended up getting frustrated with the "system" for not being able to help him. Unfortunately that frustration seems to roll down.

However I would never deny him care...

Edited July 18, 2012 by djdudley

[ERDoc]

Personally I'd rather deal with someone with psych issues than the drunks the cops always bring in. Just because someone is drunk does not mean they have a medical problem. They suck up a bed in the ER for 10+ hours while they sober up. Granted they are easy to care for (H&P, leave them in the hall where they can be watched) but that is a bed I could use for someone who actually has a medical problem.

[Kiwiology]

Good points raised by all, it is just extremely frustrating when people single out the "bullshit nutters who don't have a problem and just want attention" to rag on or talk trash about. These people have an actual medical problem and I would bet are more likely to suffer from greater morbidity and mortality or premature death than those with the vast majority of other health problems.