# Competence required while caring for people living with mental illness in the ambulance care setting: a Delphi study

## TL;DR

This study identifies the knowledge, skills, and attitudes ambulance clinicians need to care for people with mental illness using a Delphi method.

## Contribution

It provides a consensus-based framework for competence requirements in mental health care within ambulance settings.

## Key findings

- 57 statements reached consensus on competence requirements for caring for people with mental illness.
- Statements were categorized into knowledge (26), skills (13), and attitude (18).
- Ambulance clinicians need non-judgmental attitudes and mental health assessment skills.

## Abstract

People living with mental illness form a significant component of individuals presenting to emergency care services. Ambulance care embraces the care and treatment given to people of all ages who have suffered a sudden illness or injury and is carried out twenty-four-seven, regardless of setting and organizational belonging.

The aim was to explore ambulance clinicians’ competence requirements in caring for people living with mental illness.

The study had a deductive and explorative design. A Delphi method was adopted using a group of experienced individuals recruited from the emergency care chain and non-governmental organizations (N = 15). An initial open-ended questionnaire was distributed covering three questions about; (1) knowledge, (2) skills and (3) attitudes that ambulance clinicians need to care for people living with mental illness. The informants’ answers were analysed using a manifest content analysis ending up in statements designed into a questionnaire that was sent out digitally in two rounds.

The 57 statements that reached consensus could be categorised as referring to knowledge (n = 26), skills (n = 13) and attitude (n = 18).

Ambulance clinicians are expected to manage a range of incidents involving people living with mental illness, demanding knowledge of mental illness and the skills of mental health assessment, to ensure ambulance clinicians have the ability and non-judgmental attitude to make appropriate decisions within a caring encounter.

The online version contains supplementary material available at 10.1007/s44192-025-00140-6.