Article Text
Abstract
Background Suicidal behaviours and self-harm are associated with an increased risk of suicidal death and make up a significant subset of the mental health calls responded to by ambulance services.
This prehospital response provides access to medical and psychological care for patients in crisis.
A patient’s future willingness to engage with services can be compromised by early, healthcare interactions of poor quality. Despite patients and their families describing the quality of prehospital emergency care as ‘hit-and-miss’, and a reported lack of appropriate prehospital training, related international evidence on the pre-hospital staff experience is lacking.
Methods After ethical approval was obtained, experienced, registered practitioners with the Irish Prehospital Emergency Care Council were asked to participate in an online recorded, semi-structured interview. 53 expressions of interest were received. A purposively selected, maximum variant sample (n=11) consisting of EMTs, Paramedics and Advanced Paramedics was extracted, consented, and interviewed as part of an ongoing mixed methods study.
To gain a deeper understanding of an under-researched area, a descriptive design approach was used. This method will facilitate the collection of straightforward descriptions of studied phenomena that can be used to contribute to change in a practical clinical setting.
An interview guide was designed, and participants were asked about their understanding of and experiences of responding to self-harm and suicidal behaviours. Interviews were transcribed and thematic analysis described by Braun and Clark was facilitated using Nvivo software. Analysis is ongoing.
Preliminary Results Knowledge and understanding comes from colleagues, external sources, and patient interactions. Practice develops informally through trial and error. Clinical guidelines play a minimal role. Empathy and ‘soft’ interpersonal skills are deemed essential for patient care. Establishing rapport and emotional responses were often reported.
Conclusion This study highlights the experiences of responding to suicide and self-harm and suggests areas for better prehospital education and care.