Over 1,500 suicides and 15,000 suicide attempts are reported annually in Sweden. In order to tackle this, Stockholm’s care services have introduced the Psychiatric Emergency Response Team (PAM) – an ambulance dedicated only to mental health care. It’s the first of its kind in the world, essentially an emergency response therapy room that can travel at 70 miles per hour.
As it speeds across the city, PAM looks like the conventional ambulance. On the inside, however, comfortable seats have replaced stretchers, and the bright lights have been altered for a warmer glow.
The response team includes two mental health nurses and one paramedic. In Sweden, the police traditionally handle these emergency cases. By making trained professionals available for emergency response, the quality of care provided is improved. It has also minimised the stigmatization of patients with psychiatric problems.
In Stockholm, PAM responds to over 130 calls per month on average. The vast majority of these calls relate to suicidal risk.
Anki Björnsdotter works as a mental health nurse, and gave a small insight into working with PAM:
What is a typical kind of call you get?
We help people who are suicidal and people who suffer from severe mental illness. It can be someone who is manic and not aware of their own mental state, such as a person who needs to go to a hospital without realising they need to. Also, people who are psychotic and people suffering from schizophrenia who haven’t taken their medicine and are in distress.
It used to be the police who handled these kinds of calls. But just the presence of the police can easily cause a patient to feel like they’ve done something wrong. Mental illness is nothing criminal so it doesn’t make sense to be picked up by the police.
How do you handle these cases?
When we first arrive at the scene, we evaluate the situation. If it’s a suicide case, it can take some time before you reach a contact person or someone who’s able to calm the patient down. We talk to the person in order to make a call about whether we should bring the patient to the hospital, or give them a ride home.
For example, if we get a call about a person on a bridge about to commit suicide and things have cooled down by the time we arrive, we might consider the situation and decide that, in this particular case, the patient won’t try to commit suicide after all and won’t need to be hospitalised.
During its first year of operation, PAM was requested 1,580 times, and had 1,254 cases attended to. That’s an average of 4.3 requests and 3.4 cases per day. 1,036 individuals of all ages were attended to, and 96 of them had contact more than once. One third of all attended cases resulted in no further action after a psychiatric assessment and sometimes crisis intervention had been made on site.
It is a scheme that is widely believed in, offering the right response to such delicate emergencies. PAM plans to continue operating in Stockholm after a successful trial, according to Fredrik Bengtsson, Head of Mental Health Emergency at Sabbatsberg Hospital. “I can’t see any reason as to why the project shouldn’t continue,” Bengtsson told VICE Sweden. “It has been considered a huge success by police, nurses, healthcare officials, as well as by the patients.”
Currently, Stockholm is the only Swedish city to have taken such measures to reduce suicide rates. However, Because of its success, other regions – like Skåne, Örebro, Blekinge and Jönköping are all looking into the possibility of using PAM. In Gothenburg, they have already set up a scheme that takes mental health nurses to emergencies by car, again delivering the right type of care for patients suffering from poor mental health.