From Anxiety to Psychosis: Managing Mental Health in Pre-Hospital Care. Mental Health Part 3

In pre-hospital care, paramedics regularly encounter patients with a wide range of mental health conditions. From anxiety and depression to psychosis and self-harm, the ability to quickly assess and manage these conditions is crucial in ensuring the best possible outcome for the patient. But how do paramedics navigate the complexities of mental health?In the field, where resources are limited and time is critical. In this episode, we explore the most encountered mental health pathologies in pre-hospital care, focusing on how paramedics assess, manage, and provide care for these patients under high-pressure circumstances. From acute anxiety attacks to bipolar disorder episodes, we discuss the unique challenges paramedics face when dealing with patients experiencing severe psychological distress.We’ll also delve into the importance of collaboration between paramedics, mental health crisis teams, and other emergency responders (Multi-Disciplinary Team/MDT approaches). How do these teams work together to ensure a seamless care pathway for patients who may need urgent mental health support? This episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

This is the second installment from Ryan Atkinson's blog post, "Let's talk about climate hypocrisy and carbon democracy…," which addresses the common accusation of hypocrisy faced by environmental activists. Ryan, a filmmaker focusing on conservation, acknowledges his own air travel, which contributes to global CO2 emissions, yet argues it is necessary for communicating and effecting systemic change. He frames such criticism as a personal attack designed to shut down debate, suggesting that living a perfectly non-hypocritical life within a carbon-dependent society is nearly impossible for those seeking to make an impact. Instead, he advocates for embracing perceived hypocrisy as a starting point for dialogue about climate change and the pervasive influence of the carbon economy. Ultimately, the blog champions the idea that individual actions, even imperfect ones, can contribute to larger structural change if they serve a greater purpose. You can read the blog post here: https://ryanatkinson.tv/2020/03/02/lets-talk-about-climate-hypocrisy-and-carbon-democracy/This episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Today, we are joined by Dr Celestine Weegenaar, the first female PHEM trainee at Great Western Air Ambulance Charity (GWAAC). Originally from Amsterdam and now firmly rooted in the South West of England, Celestine brings a wealth of experience from emergency departments across the region – and even from the skies of Australia, where she flew with LifeFlight.We talk about her journey into pre-hospital emergency medicine, what drew her to the field, and how she’s navigating the challenges and rewards of her current role. From the adrenaline of high-acuity pre-hospital care to the quiet moments of learning and growth alongside GWAAC’s critical care team, Celestine reflects on the reality of life as a trainee in this dynamic and demanding specialty.As the new Chair of the Pre-Hospital Emergency Medicine Trainees’ Association (PHEMTA), she also shares her vision for increasing inclusivity in the field, breaking down barriers, and supporting more women to pursue careers in PHEM. Whether you're an aspiring critical care clinician or simply interested in the people behind the patch, this episode offers a personal and inspiring look into the life and values of a rising leader in pre-hospital care.This episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Ryan Atkinson's "Local Loss in a Global Crisis" explores the disconnect between Western perceptions of climate change and its tangible effects on vulnerable communities, specifically in the Langtang Valley of Nepal. Ryan reflects on his personal carbon footprint and the ethical implications of his travels while witnessing the devastation caused by the 2015 earthquake, exacerbated by climate change. Ryan highlights the resilience and enduring spirit of the local people, who face immense challenges despite having contributed little to the global crisis. The piece ultimately underscores the profound impact of global environmental issues on local lives, compelling Ryan to advocate for these stories. You can read the blog post here: https://ryanatkinson.tv/2020/02/22/local-loss-in-a-global-crisis/This episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

Every year, thousands of lives are lost to suicide, and emergency responders are often the first line of support during these critical moments. In this episode, we explore the vital role that the London Ambulance Service (LAS) plays in suicide prevention and risk assessment. From the moment a call comes into the control room to the interaction on the frontline, paramedics are trained to recognise the signs of suicidal ideation and act quickly to prevent harm.We’ll dive into the clinical and operational aspects of suicide risk management, discussing how paramedics assess high-risk patients and work alongside police, mental health crisis teams, and hospitals to ensure the best possible care. You’ll learn about the collaborative efforts that help create a seamless response for those in the most vulnerable states, as well as the challenges involved in coordinating care across various agencies.This episode offers a candid look at the realities of suicide prevention in pre-hospital care and the steps that can be taken to save lives.

In this episode, we reflect on the article “Asking Why. Telling Stories. Owning Accountability” and its lessons for both the diving community and pre-hospital care. The piece explores how adverse events are too often met with blame and silence, when what’s needed is open storytelling, systemic accountability, and visible learning. Drawing on three academic theses, the author argues for a shift from backward-looking, individual blame towards forward-looking, relational accountability approaches that foster trust, resilience, and safer systems.Barriers such as fear of reputational harm and legal concerns frequently stifle honest reflection. Yet, the article suggests that structured, context-rich narratives can create a culture of genuine learning and justice, allowing organisations to adapt and prevent future harm.For pre-hospital care, the parallels are striking. Just like in diving, providers face high-stakes environments where “first stories” may oversimplify, overlooking the complex contexts in which clinicians operate. Whether in remote environments, critical incidents, or everyday EMS work, learning requires moving past blame and toward systems thinking. Transparent communication, structured debriefs, and the courage to challenge norms are as vital to paramedics and pre-hospital teams as they are to divers and expedition leaders.By embracing this approach, telling richer stories, strengthening feedback loops, and redefining accountability, we can better support both patients and providers in the moments when things go wrong. Read the blog post here: https://www.thehumandiver.com/blog/asking-why-telling-stories-and-owning-accountability-lessons-for-divingYou can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025

Today, we’re exploring some of the complexities of real-life palliative care cases that frontline staff have faced in practice. Joining me are four members of the London Ambulance Service’s dedicated Palliative and End-of-Life Care Team: Karina Catley, Natalie Nabunya, Rowena Rickson, and Jodie Grace. Together, we’ll examine real-life case studies that illustrate the unique challenges of caring for patients and their families during their final moments. From managing uncontrolled seizures in the community to supporting a family’s cultural and spiritual wishes after death, these stories highlight the difficulties of decision-making when time is limited, documentation is incomplete, and emotions are intense. Along the way, we’ll explore key principles such as the doctrine of double effect, the role of shared decision-making, and the importance of recognising dying in the field. We’ll also discuss how clinicians can communicate compassionately, respect cultural values, and navigate the legal and public health frameworks that guide this care. This is a conversation about dignity, humanity, and the privilege of supporting people at the end of their lives, offering lessons for all of us working in pre-hospital care.

This episode dives into a critical article arguing that the diving industry too often fails to learn effectively from fatalities, not because of individual mistakes, but due to systemic shortcomings. It distinguishes between “first stories”, simple narratives that assign blame, and “second stories”, deeper explorations into context, drift from safety standards, and the normalisation of deviance.The tragic death of Linnea Mills is used as a case study, showing how multiple factors, equipment incompatibility, insufficient supervision, and the challenges of a remote location, aligned to create a disaster. Rather than focusing only on compliance or individual error, the article calls for a systems-based approach to safety: stronger feedback loops, better emergency preparedness, and a culture where speaking up about risks is encouraged.For divers, instructors, and responders, this also underscores the importance of effective pre-hospital care. Here are key resources:Divers Alert Network: First Aid & Emergency CareWHO: Prehospital Trauma Care SystemsNAEMT: Prehospital Trauma Life Support (PHTLS)EMS World: Best Practices in Prehospital CareBy combining systemic safety improvements with robust pre-hospital care readiness, the industry can better prepare for emergencies and reduce the likelihood of preventable tragedies.You can read the blog post here: https://www.thehumandiver.com/blog/we-don-t-learn-from-diving-fatalities-and-here-s-whyYou can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025

Mental health crises are one of the most complex and sensitive challenges faced in pre-hospital care. The London Ambulance Service (LAS) plays a critical role in responding to these emergencies, from the moment a 999 call is made to frontline crews delivering urgent interventions. But how does the system work as a whole? How are these calls assessed in the control room, and what role do specialist paramedics and mental health professionals play in shaping patient outcomes?In this episode, we dive deep into Pre-Hospital Mental Health Response, exploring how the LAS manages real-time mental health incidents, the operational and clinical decision-making that happens behind the scenes, and the challenges of coordinating care across multiple agencies. We’ll hear about the evolving role of mental health-trained paramedics, case studies of successful interventions, and the key lessons learned from high-risk situations.Joining us are colleagues from the London Ambulance Service Mental Health Team, who will share their experiences from both the frontline and the Emergency Operations Centre (EOC), giving us a full picture of how pre-hospital mental health care is delivered in one of the busiest ambulance services in the world.This episode is a deep dive into how mental health services are integrated and embedded within an ambulance service as a fundamental part of emergency care service delivery to the population. This episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

This blog is a personal reflection from Advanced Paramedic Wayne Auton, who shares how he has recently embraced what he describes as a “position of yes.” This mindset involves being open and willing to accept opportunities as they arise, often at short notice, and focusing on the positive potential that each opportunity may bring. Wayne acknowledges that it is a fortunate position to be in, but one that has significantly transformed his outlook and boosted his overall positivity.For many years, Wayne found himself caught in a cycle of negative thinking. He often focused on what might go wrong, rather than what could go right. This tendency led to decreased confidence, increased caution, and a general reluctance to take risks. It was a mindset he found restrictive and disheartening.He reflects on how he used to default to worst-case scenarios, frequently overlooking the possible benefits of a situation. Research supports this pattern; negative events tend to be more intense and memorable because they require greater mental effort to process (Taylor, 1991). Recognising this has helped Wayne shift his focus. By choosing to say yes more often, he has created space for growth, confidence, and optimism.You’ll also hear an AI-narrated summary of this blog, bringing Wayne’s reflections to life through audio. You can read the blog here: https://wayneauton.blogspot.com/2021/03/say-yes-to.htmlThis episode is sponsored by PAX: The gold standard in emergency response bags.When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/