Psychosis is a complex mental condition that can vary in severity from mild to very serious.
ER24 professionals explain how they identify when it’s a medical emergency.
As first responders, it's crucial for ER24 paramedics to recognise the symptoms of psychosis and know when it requires immediate medical attention. By using the correct methods to calm down tense situations, ER24 paramedics can ensure that patients who are going through a crisis because of psychosis stay safe, get the care they need, and get it on time.
Common symptoms of psychosis
ER24 paramedics are often called out to cases involving mental health issues. “Psychosis is one such condition, and it’s potentially serious as it involves a lack of contact with reality to some degree. It can arise suddenly, requiring careful assessment and appropriate action,” says ER24 Trauma Support Coordinator Tammy Dicks.
People experiencing psychosis may have distorted thoughts, perceptions, and behaviours. “It can be caused by various factors, including mental illnesses like schizophrenia, bipolar disorder, severe depression, or even substance abuse,” Dicks explains. Psychosis can cause these symptoms:
- Hallucinations – false perceptions, such as hearing voices or seeing things that aren't there
- Delusions – false beliefs that are resistant to reasoning, such as believing they have special powers or are being persecuted
- Disorganised thinking and speech
- Impaired communication
- Agitation or aggression – unusually severe agitation, anxiety, or even aggressive behaviour due to altered perceptions
- Withdrawal – isolation or withdrawal from social interactions can be a sign of underlying psychosis.
Differentiating psychosis from other conditions
Not all instances of an altered mental state mean the person is experiencing psychosis. ER24 paramedics need to carefully evaluate the situation so they understand what’s really going on. “Conditions like intoxication, medical conditions such as a severe infection or electrolyte imbalance, or even extreme stress can lead to temporary confusion or altered mental status,” Dicks explains. “Distinguishing between these situations and genuine psychosis is essential for providing the appropriate care”.
When is psychosis an emergency?
Determining whether an incident of psychosis is a medical emergency depends on several factors, says Navesh Singh, ER24 East Metro Branch Manager:
- The ER24 paramedics first must decide if the patient is a danger to themselves or others. “This could manifest as aggressive behaviour, suicidal tendencies, or self-harm,” says Singh. “If attempts to communicate and de-escalate the situation are unsuccessful, or the patient is unable to engage in coherent conversation, they need immediate assistance.”
- When psychosis develops suddenly or escalates rapidly, it could indicate a medical emergency, especially if the patient has no history of such symptoms.
- If the patient's altered mental state is accompanied by other symptoms, such as seizures, severe agitation, or loss of consciousness, it also warrants emergency intervention.
Responding to psychosis emergencies
ER24 paramedics always follow established protocols to ensure the safety and wellbeing of the patient and those around them. “If the situation is unsafe, we wait for law enforcement backup before entering,” explains Singh. “We always approach the individual calmly and respectfully and avoid sudden movements or loud noises that might exacerbate their distress.” ER24 paramedics attempt to de-escalate the situation through non-threatening body language and speaking to them calmly and with empathy. “We always do a medical assessment to rule out any underlying medical causes or complications,” he says. “Where possible, we speak to mental health professionals to decide the best course of action.”