Today was a long day. With the focus of this class on understanding major determinants of health, much of our time will be exploring the Spanish healthcare system. Today, we sought to understand the emergency response process.
We began our journey with our first ride on the Metro (subway). First off, the Madrid Metro is impressive! Clean, cheap, safe, efficient, expansive, and easy to navigate. Even for an American with subpar Spanish speaking skills! The train took us to the Madrid public university. A modest, but fine university that is available to all for less than $2K Euro per year. No football team but that’s not really the point, is it?
The Madrid Metro…all electric, all good.
Our Madrid guide (Sara) is a lovely person and a wealth of knowledge. She spoke on the college process for young Spaniards and the differences between public and private universities. Such stark differences from the U.S. model.
Eventually Sara led us to the local emergency response hub known as SAMUR. We were lucky to connect with an English speaking volunteer who described the SAMUR system. One of the main differences is their reliance on psychological interventionists during a crisis. Rather than sending police officers as first responders to situations that are often already highly escalated, SAMUR includes psychological interventionist (Team Romeo) as part of a large team. It is Team Romeo’s job to de-escalate individuals in crisis before the situation becomes worse. This would not be possible without the well-funded (tax-funded) organization. Oh, and if you are unlucky enough to require a visit from Romeo (or an ambulance for that matter) you can rest easy knowing this will not cost you any money.
Another difference is their use of volunteers. The woman who spoke to us was a volunteer who clearly took this job very seriously. She began the discussion with an almost defensive approach. As if she was trying to protect us from something she very much loved. But when asked why she volunteers over 100 hours per year to this organization (while working full-time and for no compensation) the reason became clear. She described how the SAMUR team came to her mother’s aid when she passed several years ago. “I don’t remember much about that day other than seeing teams of people in orange and yellow vests. SAMUR was there.”
This is an impressive model. Last year, I was in Breckenridge, Colorado learning about a similar, albeit, not as well funded, model of emergency assistance for those in a mental health crisis, where social workers or other mental health professionals accompanied law enforcement on crisis calls. The outcomes were so much better than previously recorded outcomes with only LE intervention. It seems so simple!
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