Psychological vulnerability and suicidality within the ambulance service: a review

Paramedics must be physically and mentally robust to seamlessly adapt between emergencies and disasters. Developing evidence suggests that ambulance colleagues may be at higher risk of suicide; yet few studies explore causal factors and effective interventions. Mental distress, illness and associated physical symptoms of emotional injury, have long been the subject of global systematic review; however, an inadequate understanding of the cumulative anguish leading to suicidality remains. Research has shown that occupational and organisational burdens, such as shift work and extensive hours, have a significant detrimental impact upon staff welfare. Individual responses to the multifaceted work nature and subsequent influences on distress have been found to create a ‘perfect storm’ for emotional vulnerability. Inherent camaraderie and stoicism have prevented openness, and therefore stalled the improvement of psychiatric support systems. Suicidality discussions can be neglected, subsequent to mental health stigmatisms, and the absence of data reduces accurate findings, therefore underestimating the current concern. Ambulance trusts must develop policy and procedure to protect staff, lower the incidence of mental fatigue and reduce suicide. Having dedicated their lives to public safety, paramedics require robust programmes designed to protect their physical and mental welfare. These must be endorsed at the highest level, ensuring confidence and trust from the diverse workforce.