Crisis averted: How consumers experienced a police and clinical early response (PACER) unit responding to a mental health crisis

Abstract

When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015. The study highlighted that people who encountered the A-PACER team generally valued and saw the benefit of a joint police-mental health clinician team response to a mental health crisis situation in the community. In understanding what worked well in how the A-PACER team operated, consumers perspectives can be summarized into five themes: communication and de-escalation, persistence of the A-PACER team, providing a quick response and working well under pressure, handover of information, and A-PACER helped consumers achieve a preferred outcome. All consumers acknowledged the complementary roles of the police officer and mental health clinician, and described the A-PACER team's supportive approach as critical in gaining their trust, engagement and in de-escalating the crises. Further education and training for police officers on how to respond to people with a mental illness, increased provision of follow-up support to promote rehabilitation and prevent future crises, and measures to reduce public scrutiny for the consumer when police responded, were proposed opportunities for improvement.

Patients' experiences of the caring encounter with the psychiatric emergency response team in the emergency medical service—A qualitative interview study

“…An interpretation of this could be that both the EMS and police departments need more knowledge about how to take care of persons in acute psychiatric distress. The need for ambulance personnel to be trained to a higher level in caring for patients facing psychiatric emergencies is known from previous studies, and when the police work with mental health personnel, the outcome is better for the patient, the organization and the personnel . The findings of this study may also indicate shortcomings in the mental health‐care system; the patients described both a lack of trust and a lack of availability to their ordinary health‐care facilities; and the PAM sometimes becomes a substitute for other mental health caregivers.…”

“…The patients wanted them to arrive in silence; they did not want their neighbours to know about their illness. How to achieve the balance between avoiding public scrutiny and ensuring a rapid response is an issue for further consideration, as highlighted and also discussed in a previous study …”

“…6 Accordingly, alternative response systems for psychiatric emergencies have been developed and evaluated over the years, and the use of specialized psychiatric response organizations as part of law enforcement and/or the EMS has been shown to be positive overall from the perspective of the personnel and the organizations. [7][8][9][10][11][12][13][14] Previous studies have also shown that an early response unit with special knowledge of handling patients in psychiatric emergency situations could help the patient to achieve a preferred outcome. 7 However, there is a lack of knowledge concerning the patients' perspective of the care.…”

“…Handling psychiatric emergencies such as mental health crises is both challenging and complex for EMS personnel due to their insufficient education and limited direct access to psychiatric specialist services . Accordingly, alternative response systems for psychiatric emergencies have been developed and evaluated over the years, and the use of specialized psychiatric response organizations as part of law enforcement and/or the EMS has been shown to be positive overall from the perspective of the personnel and the organizations . Previous studies have also shown that an early response unit with special knowledge of handling patients in psychiatric emergency situations could help the patient to achieve a preferred outcome .…”

Police and mental health responses to mental health crisis in the Waikato region of New Zealand

“…Co‐response models that combine an emergency response with specialist mental health knowledge and skills are common internationally (Evangelista et al . ; Reveruzzi & Pilling ), with research indicating that mental health nurses attending community crises with police can reduce the degree of exposure to law enforcement processes that service users might otherwise face (Kisley et al ., ). The introduction of co‐response model in the Waikato and other New Zealand regions might make positive contributions, particularly if focused on a targeted approach to after‐hours responses when contact between service users and police is more likely.…”