Renaissance School of Medicine (Farquharson, Schwartz, Carlson) and Department of Psychology (Klein), Stony Brook University, Stony Brook, New York.
Psychiatr Serv. 2023 May 1;74(5):488-496. doi: 10.1176/appi.ps.202200028. Epub 2022 Oct 27.
Sensational headlines describing police entanglements with young children have prompted questions about how often these incidents occur and why. The authors of this cross-sectional study examined the factors associated with police versus nonpolice arrivals to the psychiatric emergency room and those predicting subsequent police arrivals.
Electronic medical records of children ages 5.0-12.9 years brought to a comprehensive psychiatric emergency program (CPEP) at a university hospital were reviewed to determine whether a child was brought by police ("police arrival") in response to a 911 call by school personnel, a mental health or other medical professional, or a caregiver. Extracted data included the child's age, sex, race-ethnicity, family makeup, insurance status, arrival status, referral source, diagnosis, disposition, treatment, number of CPEP and police encounters, and occurrences of aggression and suicidality. Multilevel and ordinary logistic regression models were used to identify factors associated with a first and subsequent police arrival.
Of 339 children with CPEP encounters from September 2017 to April 2018, 103 (30%) had had at least one police arrival. Children brought by police were more likely than peers brought by caregivers to be Black or Latinx, have Medicaid, come from families without two parents, and have aggressive outbursts or suicidal behavior. Results from multilevel logistic regression indicated that aggressive outbursts and suicidality were most significantly and consistently associated with experiencing both a first and subsequent police arrival.
Clinical and sociodemographic differences in police arrivals highlight the need for a comprehensive systems approach for children, especially marginalized youths, who need psychiatric emergency care.
描述警察与儿童纠缠的耸人听闻的标题引发了人们的疑问,即这些事件发生的频率以及原因。本横断面研究的作者检查了与警察与非警察到达精神病急诊室相关的因素,以及预测随后警察到达的因素。
对一所大学医院综合精神病急诊计划(CPEP)收治的 5.0-12.9 岁儿童的电子病历进行回顾性分析,以确定儿童是否因学校人员、心理健康或其他医疗专业人员或照顾者拨打 911 电话而被警察(“警察到达”)带到 CPEP。提取的数据包括儿童的年龄、性别、种族-民族、家庭构成、保险状况、到达状况、转介来源、诊断、处置、CPEP 和警察接触次数、攻击和自杀行为发生次数。使用多级和普通逻辑回归模型来确定与首次和随后警察到达相关的因素。
2017 年 9 月至 2018 年 4 月期间,共有 339 名儿童在 CPEP 就诊,其中 103 名(30%)至少有一次警察到达。与由照顾者带来的同龄人相比,由警察带来的儿童更有可能是黑人和拉丁裔,拥有医疗补助,来自没有双亲的家庭,有攻击性发作或自杀行为。多级逻辑回归结果表明,攻击性发作和自杀行为与首次和随后的警察到达最显著且一致相关。
警察到达的临床和社会人口统计学差异突出表明,需要对需要精神病急诊护理的儿童,特别是处于边缘地位的青少年,采取全面的系统方法。