Perceptions of the Paris Fire Brigade regarding psychiatric emergencies

OBJECTIVE: This study explored the perceptions of Paris firefighters regarding psychiatric emergency interventions in a context of increasing collaboration with the psychiatric mobile emergency medical service in Paris (SAMU-psy). METHODS: An online questionnaire was distributed to Parisian firefighters working in central Paris from May to June 2025. Responses were analyzed descriptively. RESULTS: In total, 924 firefighters responded. They reported near-daily exposure to psychiatric situations, often perceived as complex. The most frequently encountered cases involved behavioral disturbances related to substance use (82.6%) and suicidal ideation (54.6%). Firefighters described feelings of mistrust (84.1%) but also empathy (53.3%) during these interventions. Nearly 42% reported lacking specific knowledge, and 44.5% expressed a desire for further training. Reported challenges included communication with patients, especially when care was refused, coordination with other emergency services, and emotional exhaustion. Overall, 15.8% of firefighters had previously participated in a joint intervention with the SAMU-psy. These collaborations were generally considered helpful for de-escalation or decision-making support. CONCLUSION: This study highlights the tensions, needs, and perceptions firefighters experience in psychiatric emergency situations in Paris. It emphasizes the relevance of enhanced training, more systematic access to specialized psychiatric support, and improved inter-institutional coordination to strengthen prehospital psychiatric emergency care.