Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand.
Biostatistics Group, Dean's Department, University of Otago Wellington, Wellington, New Zealand.
J Psychiatr Ment Health Nurs. 2023 Aug;30(4):822-835. doi: 10.1111/jpm.12916. Epub 2023 Mar 18.
Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under-prepared. The single frontline service approach is time-intensive and risks a coercive pathway to care. The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal.
Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services. Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services. Police and ambulance staff found it hard to work with mental health services.
The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes. Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls. New models such as co-response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated.
INTRODUCTION: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi-agency perspectives of such work.
AIM/QUESTION: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide-related crises in Aotearoa New Zealand and to discover how they experience current models of cross-agency collaboration.
A descriptive cross-sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis.
Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter-agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff.
Frontline services struggle managing mental health-related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services.
The single-agency frontline response may be detrimental to service users in crisis and under-utilizes the skills of mental health staff. New ways of inter-agency cooperation are required, such as co-located police, ambulance and mental health nurses responding in partnership.
警察和救护人员越来越多地被要求帮助那些经历心理健康危机的人，但他们往往感到准备不足。单一的一线服务方法需要大量的时间，并且存在强制性的护理途径。尽管急诊部门被认为不是最佳选择，但它仍是警察或救护人员转介涉及心理健康危机人员的默认位置。
警察和救护人员难以满足心理健康需求，他们报告说心理健康培训不足，在尝试从其他服务中获得帮助时几乎没有享受和积极的体验。大多数心理健康工作人员接受过充足的心理健康培训，并且喜欢他们的工作，但许多人在从其他服务中获得帮助时遇到了困难。警察和救护人员发现与心理健康服务机构合作很困难。
有限的培训、不良的机构间转介流程以及难以获得心理健康服务支持，意味着当警察和救护服务机构单独应对心理健康危机时，可能会加剧和延长危机人员的痛苦。为急救人员提供更强化的心理健康培训和更精简的转介流程可能会改善流程和结果。精神科护士拥有关键技能，可用于协助应对 911 紧急心理健康电话的警察和救护人员。新的模式，如联合反应小组，警察、心理健康临床医生和救护人员共同响应，应该进行试验和评估。
引言：急救人员越来越多地被要求帮助那些经历心理健康危机的人，但几乎没有研究涉及多机构对这种工作的看法。
目的/问题：了解在新西兰参与心理健康或自杀相关危机的警察、救护人员和心理健康工作人员的观点，并发现他们如何体验当前的跨机构合作模式。
采用混合方法的描述性横断面调查。使用描述性统计和内容分析对定量数据进行分析，并对自由文本进行内容分析。
参与者包括 57 名警察、29 名救护人员和 33 名心理健康专业人员。心理健康工作人员感到培训充分，但只有 36%的人描述了良好的获取机构间支持的流程。警察和救护人员感到培训不足和准备不足。89%的警察和 62%的救护人员认为获得心理健康专业知识很困难。
一线服务在管理与心理健康相关的 911 紧急情况方面存在困难。当前的模式效果不佳。警察、救护和心理健康服务机构之间存在沟通不畅、不满和不信任。
单一机构的一线反应可能对危机中的服务用户不利，并未能充分利用心理健康工作人员的技能。需要新的机构间合作方式，例如，警察、救护和精神科护士共同合作，联合应对。
