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EMS News in Focus
by Arthur Hsieh

Tips for handling mental health patients

By Arthur Hsieh

Editor's note: A new program in Maine will focus on training police officer, medics, corrections officers and others in methods for dealing with people in the throes of a mental health crisis.

Mental illness and behavioral emergencies can be a major challenge for many EMS providers. Because we often don't have firsthand or personal knowledge about psychiatric illneess, it can be difficult to empathize with a patient whose chief complaint has no apparent physical signs.

More importantly, while we might train for the obviously psychotic patient, there are many more instances of patients experiencing acute behavioral crisis in our practice. How we engage and interact with those patients can often defuse — and unfortunately, sometimes inflame — the situation.

While this article speaks about the experiences found in law enforcement, the key principles still apply.

  • Recognizing that an acute psychiatric condition might exist is a big step forward in creating the environment necessary to appropriately manage the patient. 
  • Maintaining respect and empathy will help establish the trust necessary for the patient to remain cooperative and calm. 
  • Remaining vigilant for signs of an impending outburst or violent behavior will keep you, and your patient, safe.

Finally, never take it personally. Your patients don't know you, even with that uniform on. What a patient might say or do in the heat of the moment has nothing to do with you as an individual. Keep in mind that you are there because the patient is having a bad day, not a good one.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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