Prehospital care providers' understanding of responsibilities during a behavioural emergency.

backgroundPrehospital emergency care providers are frequently called to assist with the management of mental healthcare users (MHCUs). The

aimTo investigate prehospital emergency care providers' understanding of their responsibilities towards MHCUs and the community during the management of behavioural emergencies.

settingThe 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.

methodsA 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.

resultsA 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.

conclusionParticipants 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.