Examining Mental Health Act usage in an urban emergency department

Derrick, Kate; Chia, Justin; O’Donovan, Sarah; Emerton, Alexandra; Hamlyn, Marika; Wand, Timothy

doi:10.1177/1039856215590255

Cited by 9 publications

(14 citation statements)

References 6 publications

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“…; Derrick et al . ), it is possible that police‐only teams are unable to identify those who require a full psychiatric assessment. To add greater clarity, future studies might consider comparing service user, responder, and interaction characteristics in crises resulting in ED escorts to those where crises are resolved onsite.…”

Section: Discussionmentioning

confidence: 99%

“…Second, it is possible that police-only teams underrefer service users to hospital. While research indicating that most service users brought to ED by police are not admitted to hospital suggests that underreferral might not be an issue (Al-Khafaji et al 2014;Derrick et al 2015), it is possible that police-only teams are unable to identify those who require a full psychiatric assessment. To add greater clarity, future studies might consider comparing service user, responder, and interaction characteristics in crises resulting in ED escorts to those where crises are resolved onsite.…”

Section: Discussionmentioning

confidence: 99%

“…), use of force (Rossler & Terrill ), and escorts to hospital (Derrick et al . ). Some service users report poor treatment by police officers, creating a negative crisis‐response experience and generating mistrust in subsequent police interactions (Watson et al .…”

Section: Introductionmentioning

confidence: 97%

“…In the absence of adequate community mental health crisis services, police officers have become a central component of mental health crisis-response systems in many jurisdictions, raising concerns about potential unnecessary arrests (Charette et al 2014;Crocker et al 2009), use of force (Rossler & Terrill 2016), and escorts to hospital (Derrick et al 2015). Some service users report poor treatment by police officers, creating a negative crisis-response experience and generating mistrust in subsequent police interactions (Watson et al 2008).…”

Section: Introductionmentioning

confidence: 99%

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Co‐responding police–mental health programmes: Service user experiences and outcomes in a large urban centre

Lamanna

Shapiro

Kirst

et al. 2017

Int J Mental Health Nurs

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As police officers are often the first responders to mental health crises, a number of approaches have emerged to support skilled police crisis responses. One such approach is the police-mental health co-responding team model, whereby mental health nurses and police officers jointly respond to mental health crises in the community. In the present mixed-method study, we evaluated outcomes of co-responding team interactions at a large Canadian urban centre by analysing administrative data for 2743 such interactions, and where comparison data were available, compared them to 16 226 police-only team responses. To understand service user experiences, we recruited 15 service users for in-depth qualitative interviews, and completed inductive thematic analysis. Co-responding team interactions had low rates of injury and arrest, and compared to police-only teams, co-responding teams had higher overall rates of escorts to hospital, but lower rates of involuntary escorts. Co-responding teams also spent less time on hospital handovers than police-only teams. Service users valued responders with mental health knowledge and verbal de-escalation skills, as well as a compassionate, empowering, and non-criminalizing approach. Current findings suggest that co-responding teams could be a useful component of existing crisis-response systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Co‐responding police–mental health programmes: Service user experiences and outcomes in a large urban centre

Lamanna

Shapiro

Kirst

et al. 2017

Int J Mental Health Nurs

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“…They suggest giving ED medical officers the power to discharge patients from the MHA after completing a psychiatric evaluation. 3 Derrick et al 4 conclude that since ED physicians at their site had been authorised under the MHA, the LOS has decreased.…”

Section: Discussionmentioning

confidence: 99%

Presentations by ambulance under the NSW Mental Health Act to an emergency department with a 24-hour mental health team

Skopek

2016

Australas Psychiatry

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A 24-hour ED mental health team provided specialised assessment and management for patients, alongside the necessary emergency medical intervention. This team assisted in easing the increasing pressure on the ED and minimising the patients' length of stay. The team redirected patients requiring admission, facilitated timely discharge of others and revoked Section 20 when less restrictive care was appropriate.

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Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care

et al. 2022

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Acute services for mental health crises are very important to service users and their supporters, and consume a substantial share of mental health resources in many countries. However, acute care is often unpopular and sometimes coercive, and the evidence on which models are best for patient experience and outcomes remains surprisingly limited, in part reflecting challenges in conducting studies with people in crisis. Evidence on best approaches to initial assessment and immediate management is particularly lacking, but some innovative models involving extended assessment, brief interventions, and diversifying settings and strategies for providing support are potentially helpful. Acute wards continue to be central in the intensive treatment phase following a crisis, but new approaches need to be developed, evaluated and implemented to reducing coercion, addressing trauma, diversifying treatments and the inpatient workforce, and making decision‐making and care collaborative. Intensive home treatment services, acute day units, and community crisis services have supporting evidence in diverting some service users from hospital admission: a greater understanding of how best to implement them in a wide range of contexts and what works best for which service users would be valuable. Approaches to crisis management in the voluntary sector are more flexible and informal: such services have potential to complement and provide valuable learning for statutory sector services, especially for groups who tend to be underserved or disengaged. Such approaches often involve staff with personal experience of mental health crises, who have important potential roles in improving quality of acute care across sectors. Large gaps exist in many low‐ and middle‐income countries, fuelled by poor access to quality mental health care. Responses need to build on a foundation of existing community responses and contextually relevant evidence. The necessity of moving outside formal systems in low‐resource settings may lead to wider learning from locally embedded strategies.

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Examining Mental Health Act usage in an urban emergency department

Cited by 9 publications

References 6 publications

Co‐responding police–mental health programmes: Service user experiences and outcomes in a large urban centre

Co‐responding police–mental health programmes: Service user experiences and outcomes in a large urban centre

Presentations by ambulance under the NSW Mental Health Act to an emergency department with a 24-hour mental health team

Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care

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