Paramedic performance when managing patients experiencing mental health issues - Exploring paramedics' Presentation of Self

Introduction: Mental health is a growing global concern with a significant rise in patients calling emergency services to respond to their needs. Paramedics in the UK are increasingly being asked to respond to this increase in demand. Aim: This study explores how paramedics perform in practice when managing patients experiencing mental health issues. Methods: Qualitative observation over 240 h and interviews involving 21 paramedics and 20 patients with mental illness. Results: Using Goffinan's seminal text Presentation of Self to frame the analysis the findings of this study reveal that paramedics 'perform on two stages: front stage and back stage. Their coping mechanisms, in the metaphorical sense, include props such as uniform and scripts filled with humour, stereotyping and nostalgia to aid in their management of this specialist patient group. Conclusions: Paramedics feel frustrated and unsupported when dealing with patients experiencing mental health issues. This study identifies the coping mechanisms paramedics use to manage this patient group but questions the longevity of these mechanisms and therefore recommends additional support for paramedics with further supportive education around mental health.