Background: Paramedics are vital to the health system response to the COVID-19 pandemic; however, the pressures on this workforce have been intense and challenging. This study reports on mental health symptoms and the working environment among Australian paramedics during the COVID-19 pandemic and explores their experiences of work and wellbeing during this time. Methods: An anonymous, online survey of frontline healthcare workers examined work environment, psychological wellbeing, and contained four open-ended qualitative items. Using a mixed method approach, quantitative data were analysed descriptively and qualitative data were analysed using content analysis. Results: This paper reports findings from 95 paramedics who provided complete quantitative data and 85 paramedics who provided free-text responses to at least one qualitative item. Objectively measured mental health symptoms were common among paramedics, and almost two thirds of paramedics self-reported experiencing burnout. Qualitative analysis highlighted key issues of safety and risk in the workplace, uncertainty and upheaval at work and at home, and lack of crisis preparedness. Qualitative analysis revealed four themes; ‘the pervasiveness of COVID-19 disruptions across all life domains’; ‘the challenges of widespread disruption at work’; ‘risk, uncertainty and feeling unsafe at work’, and ‘the challenges of pandemic (un)preparedness across the health system’. Conclusions: The COVID-19 pandemic resulted in considerable occupational disruption for paramedics and was associated with significant negative impacts on mental health. Findings emphasise the need for more adaptive working conditions, mental health support for paramedics, and enhanced crisis preparedness across the health system for future crises.
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