Encounters between people with mental health and/or substance use problems and ambulance clinicians: a qualitative interview study in Norway.
BMC Psychiatry · 2026-08-21 · Qualitative study
Abstract
BACKGROUND: Interactions between ambulance clinicians and people with mental health and/or substance use problems are frequent, and international studies show that these encounters are often shaped by stigma, power dynamics and challenges to patient autonomy. However, there is limited research exploring patients' experiences of ambulance services in the Norwegian context. This study addresses this knowledge gap. METHODS: This qualitative study was based on in-depth, semi-structured interviews with 23 people with mental health and/or substance use problems recruited from primary and specialized healthcare services and service user organizations. The data were analyzed using reflexive thematic analysis, with input from a multidisciplinary stakeholder group throughout the research process. RESULTS: Participants reported varied experiences in their encounters with ambulance clinicians. Prior interactions with other healthcare services strongly shaped their expectations of, and willingness to seek, emergency care. While some described professional and reassuring care, others experienced patronizing attitudes toward conditions perceived as self‑inflicted. Several participants also reported inadequate physical health assessments and treatment, and many felt excluded from decision‑making processes due to limited information, involvement, and respect. These experiences influenced their sense of safety, autonomy, and trust in emergency services. CONCLUSIONS: In Norway, people with mental health and/or substance use problems described several challenges in their encounters with ambulance services, including stigma, patronizing attitudes, inadequate physical healthcare, and limited patient involvement. These findings highlight the need for improved competence in mental health and substance use and clearer communication practices to promote more equitable and respectful ambulance care.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Clinician perspective · Communication & handover · Equity & disparities · Paramedics & EMTs · Patient experience · Socially vulnerable groups
Related articles
- Current emergency response in montreal: How does it fit in the services offered to homeless people who use substances? (Int J Drug Policy, 2020)
- Exploring paramedic care for First Nations in Alberta: a qualitative study. (CMAJ Open, 2023)
- Cultural safety in paramedic practice: experiences of Māori and their whānau who have received acute pre-hospital care for cardiac symptoms from paramedics. (J Prim Health Care, 2024)
- Upholding te mana o te wā: Māori patients and their families' experiences of accessing care following an out-of-hospital cardiac event. (Am Heart J Plus, 2023)
- Perceptions of Prehospital Care for Patients With Limited English Proficiency Among Emergency Medical Technicians and Paramedics. (JAMA Netw Open, 2023)
- Compassion in mental healthcare: considerations for paramedic practice (Journal of Paramedic Practice, 2026)