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Prehospital care providers’ understanding of responsibilities during a behavioural emergency


Charnelle Stander
Peter Hodkinson
Enrico Dippenaar

Abstract

Background: Prehospital emergency care providers are frequently called to assist with the management of mental healthcare users (MHCUs). The Mental  Health Care Act no. 17 of 2002 regulates mental healthcare in South Africa, but the act fails to consider the responsibilities of prehospital  emergency care providers in the provision of mental healthcare. Rather South African Police Services were given authority over the well-being of a MHCU  in the prehospital setting.


Aim: To investigate prehospital emergency care providers’ understanding of their responsibilities towards MHCUs and the community during the  management of behavioural emergencies.


Setting: The research was carried out at prehospital emergency care providers from the three main levels of care, currently operational within the  boundaries of Pretoria, South Africa.


Methods: A grounded theory qualitative study design was chosen using semi-structured focus groups for each level of prehospital emergency care –  basic life support (BLS), intermediate life support (ILS) and advanced life support (ALS). Data from each focus group were collected through audio  recordings and transcribed and analysed using a framework approach.


Results: A total of 19 prehospital emergency care providers participated; two focus group interviews were performed for each level of care. The BLS focus  groups each consisted of two participants. The ILS focus groups consisted of three participants each, and the ALS focus groups consisted of six and  three participants. Four key themes were identified: perceptions of behavioural emergencies, responsibilities, understanding of legislation and  barriers experienced.


Conclusion: Participants placed high value on their moral and medical responsibilities towards MHCUs, which they described as ensuring the safety of  themselves, MHCUs and the community; preventing further harm; and transporting MHCUs to an appropriate healthcare facility. There was a desire for  revision of legislation, better education, skill development and awareness of mental healthcare in the prehospital emergency care setting. 


Journal Identifiers


eISSN: 2078-6786
print ISSN: 1608-9685