Mental health assessment and triage in an ambulance clinical contact centre

Abstract

Background: With increasing numbers of emergency calls to ambulance services, exploration of the triage and management of mental health calls is valuable, given their volume and duration. Studies have explored these calls from patient and practitioner perspectives, but few have considered the perspective of the practitioners assessing patients over the phone in terms of clinical capability. Aim: This study aimed to explore the thoughts, feelings and educational requirements of paramedics and nurses working on emergency medical services clinical desks, focusing on mental health-related calls and the triage tools used. Methods: A service evaluation was conducted. A questionnaire was developed and distributed to 41 staff on clinical desks at the Welsh Ambulance Service Trust's (WAST) clinical contact centres in June 2019. Quantitative data was analysed using descriptive statistics and qualitative data by thematic analysis. Findings: Out of the 41 employees, 26 (63%) responded. Low levels of confidence were reported in managing mental health calls, along with inadequate detail in the mental health elements of their triage algorithm and deficiencies in referral pathways. Conclusion: Given the volume and complexity of mental health calls to ambulance services, more attention should be paid to the education and training of clinical desk professionals and the decision support tools available in WAST and other ambulance services. Further research is required with a larger sample size over multiple ambulance services.