School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia.
School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.
Int J Ment Health Nurs. 2017 Dec;26(6):580-592. doi: 10.1111/inm.12284. Epub 2016 Nov 29.
Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA. Sixteen interviews were conducted; most (n = 14) interviews in northern NSW regions: six with people who had been transported (consumers), four with carers, and six with service providers (two police, one paramedic, and three mental health nurses). For consumers and carers, the police response was often perceived as too intense, particularly if the person was not violent. Carers were often conflicted by having to call for emergency intervention. Service providers were frustrated by a lack of a coordinated interagency response, resourcing issues, delays at emergency departments, and lack of adequate training. A central theme across all groups was the importance of communication styles. As one participant (consumer) said: 'Everybody needs a lesson in kindness'. All groups agreed that high-risk situations necessitate police involvement. However, invocation of the MHA during a high-risk situation is fraught with stress and difficulties, leaving little room for empathetic communications. Effective and diverse, evidence-based, early intervention strategies - both consensual and non-consensual - are necessary to reduce the requirement for police involvement in mental health transports.
在澳大利亚，警方历来负责在精神健康危机期间运送人员。2007 年新南威尔士州（新州）《精神健康法》（MHA）的一项重大修改扩大了强制性运输机构的范围，包括新州救护车（护理人员）和新州卫生署（精神健康护士）。然而，传闻描述了在实践中如何实施这些变化存在不明确的情况。这项研究旨在通过对根据 MHA 被非自愿运输的有实际经历的人进行访谈的定性分析来探讨这种不明确性。进行了 16 次访谈；大多数（n=14）访谈在新州北部地区进行：六次与被运输者（消费者），四次与护理人员，六次与服务提供者（两名警察，一名护理人员和三名精神健康护士）。对于消费者和护理人员来说，警方的反应往往被认为过于激烈，特别是如果该人不暴力的情况下。护理人员经常因为必须要求紧急干预而感到矛盾。服务提供者对缺乏协调的机构间反应、资源问题、急诊部门的延误以及缺乏足够的培训感到沮丧。所有群体都认为沟通方式很重要，这是一个核心主题。正如一位参与者（消费者）所说：“每个人都需要上一堂友善课”。所有群体都同意，高危情况需要警察介入。然而，在高危情况下援引 MHA 充满了压力和困难，几乎没有余地进行富有同情心的沟通。需要有效的和多样化的、基于证据的、早期干预策略——既包括自愿的也包括非自愿的——以减少对警察参与精神健康运输的需求。
