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危机化解:消费者如何体验警察与临床早期反应(PACER)小组对心理健康危机的应对。

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

作者信息

Evangelista Eloisa, Lee Stuart, Gallagher Angela, Peterson Violeta, James Jo, Warren Narelle, Henderson Kathryn, Keppich-Arnold Sandra, Cornelius Luke, Deveny Elizabeth

机构信息

South Eastern Melbourne PHN (previously Bayside Medicare Local), Heatherton, Australia.

Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Australia.

出版信息

Int J Ment Health Nurs. 2016 Aug;25(4):367-76. doi: 10.1111/inm.12218. Epub 2016 Mar 1.

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.

摘要

当社区中的心理健康危机情况处理不善时,可能会导致身体和情感上的伤害。本研究的目的是确定消费者对警方与心理健康服务机构合作方式的体验和看法,具体是通过阿尔弗雷德警方与临床早期反应(A-PACER)模式,来帮助处于心理健康危机中的人们。对2013年6月至2015年3月期间与A-PACER团队有直接接触的12名心理健康消费者进行了半结构化深度访谈。研究强调,遇到A-PACER团队的人普遍重视并看到了警察与心理健康临床医生联合团队应对社区心理健康危机情况的好处。在了解A-PACER团队运作中哪些方面效果良好时,消费者的观点可归纳为五个主题:沟通与缓和局势、A-PACER团队的坚持、快速响应并在压力下良好工作、信息交接以及A-PACER帮助消费者实现理想结果。所有消费者都认可警官和心理健康临床医生的互补作用,并将A-PACER团队的支持性方法描述为赢得他们信任、促使他们参与以及缓和危机的关键。提出了一些改进机会,包括对警官进行关于如何应对精神疾病患者的进一步教育和培训、增加后续支持以促进康复并预防未来危机,以及在警方做出反应时减少对消费者的公众审查措施。

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