From Frontline Practice to National Leadership: My Research Journey in Advancing Paramedic Mental Health Care

In this blog, Dr Ursula Rolfe, Associate Professor and Paramedic Science and Mental Health Lead for the Royal College of Paramedics, explores the evolution of the paramedic profession in the UK and Rolfe’s research journey focusing on improving paramedics’ ability to deliver mental health care, highlighting the need for better education, support, and evidence-based practice in managing patients with complex mental health needs.

The paramedic profession in the UK has transformed significantly over my career. When I first entered practice, paramedics were largely viewed through the lens of emergency transport and acute physical healthcare. Today, paramedics are autonomous clinicians working across urgent, emergency and community care systems, supporting patients with increasingly complex physical, psychological and social needs. This evolution closely reflects the strategic ambitions of the Royal College of Paramedics, which has championed advanced practice, research, workforce development to help shape the future of healthcare delivery.

My own research journey began on the frontline as a practising paramedic. Early in my career, I recognised that mental health-related calls were becoming an increasingly significant part of paramedic practice. Yet many of us felt underprepared to manage the complexity of these situations. We were responding to people experiencing crisis, distress, suicidal ideation and psychosis, often without consistent education or organisational support. I became increasingly interested in understanding how paramedics could be better equipped to provide compassionate, evidence-based mental health care.

This curiosity ultimately led me into research and supported my academic career. I completed my PhD in 2018, at a time when paramedic-led research was still emerging as a discipline in its own right. My research has since focused on paramedic mental health care, educational development and simulation-based learning. Much of this work has explored the experiences of frontline paramedics managing people experiencing mental health crises and the educational gaps that continue to exist.

Through national mixed-methods studies, scoping reviews and workforce research, I have examined the challenges paramedics face when delivering mental health care in increasingly pressured urgent and emergency care systems. This work has highlighted important issues around confidence, communication, risk assessment, referral pathways and professional support. It has also demonstrated the appetite amongst paramedics for more applied, flexible and practice-relevant education.

Alongside my research, I have been privileged to contribute nationally to the development of the profession through my work with the Royal College of Paramedics as National Mental Health Lead. This has included contributing to national curriculum development, mental health capability frameworks and the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) Mental Health Guidelines. I am passionate about ensuring mental health is recognised as a core component of contemporary paramedic practice.

At Bournemouth University, I have also led work focused on simulation and immersive learning to support future healthcare workforce development. My current NIHR-supported research continues this trajectory through the development of digital education interventions designed to support paramedics caring for people experiencing mental health issues.

As healthcare continues to shift from hospital-based models towards integrated community care, I believe paramedics have a vital role to play in supporting patients experiencing mental health issues. My research journey has always been driven by a desire to improve care for some of the most vulnerable people in our communities, while supporting the development of a compassionate and evidence-based paramedic workforce fit for the future.