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Sweden has unveiled a dedicated mental health ambulance
Bright yellow in colour, with flashing blue lights. From the outside, it looks like any other Swedish ambulance. Even as it races down the highway, you'd never notice anything different about it. However, a quick peek inside reveals that this particular emergency vehicle is anything but ordinary. Gone are the stretcher and first aid kits, in their place are big chairs, relaxed lighting and a desk. That's because this ambulance isn't designed to respond to broken legs or heart attacks, but to mental health emergencies.
Determined to tackle the issue and keen to reduce the burden placed on other emergency services, Stockholm's Psychiatric Emergency Response Team (PAM) was initially launched in March 2015 as part of a trial scheme.
More akin to a mobile
counsellor’s room than an ambulance, the vehicle is staffed by two mental health nurses and a paramedic and
able to provide immediate and specialised frontline help for people experiencing mental health emergencies, including those who are in imminent danger of self-harm, experiencing distress, psychotic or
suffering from schizophrenia but may have missed medication.
Just as with a regular ambulance, it's up to the crew to make decisions about whether to bring the patient in for further treatment or simply to give them someone to talk to and a lift home. During its first year, the ambulance responded to an average of 135 callouts per month, helping 1036 individuals in need of urgent care. Of these people, only a quarter went on to receive inpatient care and just 96 required repeated contact. There is no age limit for patients, and in the scheme's first year the youngest patient was just five years old, while the oldest was 100 years old.
The scheme has proven popular with both healthcare professionals and with the police who -
despite having only minimal training in mental health care - are often left to pick up the slack when mental health professionals are not available. This can not only create distress and stigma for the individuals involved, but with police inherently trained to respond to and minimise threat, can also lead to the misinterpretation of situations and unnecessary use of force against vulnerable individuals.
Under the PAM system, police will stay with the ambulance crew if requested, for example if, a patient becomes agitated or violent.
So with many other countries now facing their own mental health burdens, could the scheme be replicated elsewhere? The UK is certainly one potential candidate for the introduction of mental health ambulances, with 999 call-outs to patients dealing with mental health emergencies jumping by almost a quarter in the year 2016-2017 and paramedics responding to over 172,000 patients in crisis situations. In the period 2015-2016, 2100 people were held under Section 136 of the Mental Health Act, which allows police to take individuals to a "place of safety" for their own protection, which could be a hospital or, when no hospital beds are available, a police cell.