The evaluation of emergency mental health practices in the treatment of mental health patients at emergency scenes in South Africa

Abstract

Background: Emergency care providers regularly manage mental health patients in a pre-hospital environment. The effective treatment of the mental health patient is dependent upon the competency of the emergency care provider. Experience of the researcher both as an emergency care provider and trauma counsellor has proven that most emergency care providers, including himself do not have the competency needed to manage a mental health patient. Aims: To investigate the competency of emergency care providers to manage a mental health patient during a mental health emergency. Setting: Emergency care providers from four private ambulance services, who are registered as independent practitioners and are operational within the boundaries of the Tshwane Metropole. Methods: The competency theory as the theoretical framework was chosen and semi structured interviews were conducted to establish the level of competency of the independent emergency care providers to manage mental health patients. The competency theory constructs of knowledge, skills and attitudes and the effect of on-scene behaviour of the emergency care providers were investigated through the mode of semi-structured interviews, which were recorded, transcribed, and subsequently analysed using the competency theory as the theoretical framework.

Results: A total of 14 participants consented to participate in the study. It was found that the participants were not competent in managing mental health patients. There was an acknowledgement by the participants of these shortcomings. This made the likelihood of the acceptance of a pre-hospital mental health assessment protocol highly likely, however, there was a proviso that the pre-hospital mental health assessment protocol must be South Africanised to accommodate the multicultural diversity that is South Africa.

Conclusion: Participants acknowledged that they did not have the competency to manage mental health patients in a pre-hospital environment and that it was highly likely that the implementation of a pre-hospital mental health assessment protocol would be accepted.