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Introduction It is well recognised that mental illness causes significant morbidity and mortality, and has been identified as a national health priority. Despite this, there is a paucity of research about paramedic student perceptions and attitudes toward those experiencing mental health presentations. The objective of this study was to explore the mental health perceptions of a final year cohort of paramedic students from a regional Victorian university. Methods Final year undergraduate paramedicine students enrolled in the core subject Advanced Mental Health Practice were invited to participate in both pre- and post-subject surveys and record their perceptions of mental health using electronic questionnaires. The questionnaires used nine 5-point Likert scale questions and three multiple option questions using declarative statements. Results Of the 25 eligible students, 16 completed the pre-subject questionnaire and 12 completed both the pre- and post-subject questionnaires. The results indicated that this cohort held common myths and misconceptions relating to mental health combined with a lack of general knowledge about mental illness and its paramedic management. These perceptions altered following the introduction of the mental health subject. Conclusion The results suggest that the implementation of a mental health subject into paramedicine undergraduate curriculum has the ability to positively alter perceptions of mental health. This may lead to students acquiring the knowledge and attitudes required to manage mental health presentations.