Paramedic Perceptions of Decision-making when Managing Mental Health-related Presentations: a Qualitative Study

Background: Mental health presentations account for a considerable proportion of paramedic workload; however, the decision-making involved in managing these cases is poorly understood. This study aimed to explore how paramedics perceive their clinical decision-making when managing mental health presentations.

Methods: A qualitative descriptive study design was employed. Overall, 73 paramedics participated in semi structured interviews, and data were analyzed from transcribed interviews in NVivo.

Results: Four themes emerged that reflected participants' perceptions: the assessment process, experience, the use of documents and standard procedures, and consultation with other healthcare providers. There were conflicting perceptions about the clinical decision-making process, with perception of role having a potential impact. The dual process theory of clinical decision-making, which includes both analytical and intuitive approaches, was evident in the decision-making process.

Conclusion: Incorporating dual process theory into education and training, which highlights the strengths and weaknesses of analytical and intuitive decision-making, may reduce clinical errors made by cognitive bias. To further support clinical decision-making, additional education and training are warranted to promote critical thinking and clarify the scope of practice and roles when attending to mental health-related presentations.