The role of paramedics in the care and treatment of mental health patients has attracted limited attention in the research arena. With the introduction of new emergency provisions under Australian state and territory- based mental health legislation paramedics in some jurisdictions have now been granted the authority to detain, restrain, search and sedate behaviourally disturbed patients who require involuntary emergency medical assistance.

The granting of mental health legislative responsibilities to paramedics has heralded a new era in not only the delivery of pre-hospital mental health care but also in the way the community perceives the role and responsibility of paramedics. The introduction of these new provisions is founded on the recognition that paramedics have a key role to play in providing high quality pre hospital mental health care. The inclusion of the provisions is also aimed at reducing the proportion of patients being handcuffed and transported to hospital by police.

Drawing upon previous research which has focused on the role of paramedics in relation to mental illness (Shaban.,2005, 2006 & Roberts, 2009), this paper will detail what is currently known about mental health care in the pre-hospital setting and the clinical decision making used by paramedics when responding to mental health patients. This paper will also propose the need for further research to identify what clinical decision processes are used by paramedics when fulfilling their mental health legislative responsibilities.