EMS Ambulance 18 Aug 2022
Medical repatriation for psychiatric patients
Mental health is one of the great issues of our day. A recent study by the UK government found the number of adults reporting a “clinically significant level of psychological distress” jumped from 20.8% to nearly 30% during the first few weeks of the pandemic.
Even without the impact of COVID, however, mental health problems are a major issue for families across the globe. The World Health Organisation estimates that one in eight people – 970 million – live with some kind of mental disorder (and these are pre-pandemic figures).
Inevitably, this creates pressures in many different areas – not least when it comes to medical repatriation. Mental health problems are one of the leading causes of sickness in travellers, and one of the most common reasons for medical repatriation. Yet the issue remains largely hidden because of the stigma that surrounds mental health conditions in many countries.
Why psychiatric repatriations happen
Mental-health-related repatriations often start with an urgent phone call. A relative receives an unexpected contact from abroad. Sometimes it’s from a loved one in a distressed or confused state of mind. Often it will be from a local authority – a doctor, a policeman, even an embassy official. The problems vary: the situation might involve a breakdown, a relapse or a psychotic episode; quite often there will be accompanying circumstances, such as a traffic accident, a police incident or even imprisonment. But the consequences are the same: the family now desperately want to get their loved one home for treatment. They just have no idea how to go about it.
Why it’s important to take control
Repatriating a patient who is facing psychiatric problems may be challenging, but it’s almost always the best course of action. In the immediate term, it prevents the situation from escalating. It also provides the best means of protecting their health and safety. But this type of repatriation does require a different approach from standard medical transports.
Here’s how we approach them at EMS.
1) Get reassurance
Mental health crises are extremely stressful for the families back home. It can be very hard to get information about your patient, and there may well be language, cultural and legal barriers as well. The most important thing to know is that we can help. We deal with psychiatric cases all the time. There’s always a way to get your relative home – often very quickly. When you speak to the EMS operations team, they’ll ask you where your patient is and for their current point of contact. We can take it all on from there.
2) Establish the facts
It’s important to get the wider picture of the case as soon as possible, because this will affect the type of support and transfer your patient needs. Do they have a pre-existing mental health condition, or has the crisis come out of the blue? What other factors might have contributed to it, e.g. drugs, alcohol, reaction to medication or to trauma (experts have estimated that 5 to 10% of physical injury cases result in some form of psychological complications)?
3) Pick the right team
Once our in-house doctors have the essential facts, we can contact any medics or authorities involved in the case and put a repatriation plan into motion. We can provide specialist psychiatric doctors or nurses for the journey. We’ll also run you through the transport options. It may be possible to use a regular flight with a medical escort – or two if necessary, so one is always on-call during long journeys. For more serious cases, or ones that involve other conditions or injuries, we may suggest an air or road ambulance. We can also bring you along with us if it would be helpful for the patient.
4) Reach out to your patient
The repatriation team will make contact with your patient as soon as possible. They’re trained to get alongside them and put them at ease, which is especially important if your patient says they don’t want to come home (a common scenario). On arrival, our medics can spend hours – sometimes even days – with a patient to help them feel familiar and reassured about the team before we start the transport.
5) Solve other challenges
Psychiatric repatriations often involve accompanying problems. For instance, patients have often lost their ID and personal belongings by the time we reach them. We’ll make sure they get proper clothing, food and emergency travel documents if they need them. We can speak to the foreign embassy if necessary, and arrange translators if there are language barriers.
6) Create the right environment
There’s a lot we can do to make your patient’s journey home as smooth as possible. Much of this comes down to keeping their travelling environment calm, which is important for psychiatric repatriations. Here are some examples of how we do that:
Lounge access – to avoid unhelpful airport crowds
Priority boarding – to avoid unnecessary queues
Cabin room – creating a curtained area to make the space quiet and relaxing
Flight bed – creating a bed space within the business class seats, where possible
Sedatives – to help your patient if they’re feeling very agitated, or are anxious about flying
Private transports – by road ambulance or private jet, if you prefer to avoid commercial flights
Repatriating a loved one in distress is one of the most challenging situations any family member can face. But with the right preparation and support, we can make sure they get back home quickly and safely for ongoing care and treatment.
If you’re searching for a medical transport company to help your child or loved one get home safely from abroad, please drop our team a line today. They’ll be very happy to talk through the potential options and explain how everything works. Head to our Contact page for the details. You can also get a free, no-obligation cost estimate for your repatriation with our online pricing calculator.
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