Emergency Medical Services and "Psych Calls": Examining the Work of Urban EMS Providers

• Published in: American journal of orthopsychiatry 2015-11, Vol.85 (6), p.612-619
• Main Authors: Prener, Christopher, Lincoln, Alisa K.
• Format: Article
• Language: English
• Subjects: Adult; Allied Health Personnel; Attitude of Health Personnel; Client Attitudes; Drug Abuse; Emergency medical care; Emergency Medical Services; Emergency Medical Technicians - psychology; Emergency Services; Health; Health care policy; Health problems; Health Services Misuse; Human; Humans; Medical personnel; Mental Disorders; Mental Disorders - therapy; Mental health; Mental health care; Mental Health Services; Paramedics; Policy making; Qualitative Research; Social interaction; Social support; Substance abuse; Therapeutic Processes; Urban Environments; Urban Population
• ISSN: 0002-9432; 1939-0025
• DOI: 10.1037/ort0000077

Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs.