Nataliansyah M Muska, Merchant Kimberly A S, Vakkalanka J Priyanka, Mack Luke, Parsons Seth, Ward Marcia M
Department of Surgery, Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee, WI, United States.
Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, United States.
JMIR Ment Health. 2023 Mar 20;10:e42610. doi: 10.2196/42610.
A mental health crisis can create challenges for individuals, families, and communities. This multifaceted issue often involves different professionals from law enforcement and health care systems, which may lead to siloed and suboptimal care. The virtual crisis care (VCC) program was developed to provide rural law enforcement with access to behavioral health professionals and facilitated collaborative care via telehealth technology.
This study was designed to evaluate the implementation and use of a VCC program from a telehealth hub for law enforcement in rural areas.
This study used a mixed methods approach. The quantitative data came from the telehealth hub's electronic record system. The qualitative data came from in-depth interviews with law enforcement in the 18 counties that adopted the VCC program.
Across the 181 VCC encounters, the telehealth hub's recommended disposition and the actual disposition were similar for remaining in place (n=141, 77.9%, and n=137, 75.7%, respectively), voluntary admission (n=9, 5.0%, and n=10, 5.5%, respectively), and involuntary committal (IVC; n=27, 14.9%, and n=19, 10.5%, respectively). Qualitative insights related to the VCC program's implementation, use, benefits, and challenges were identified, providing a comprehensive view of the virtual partnership between rural law enforcement and behavioral health professionals.
Use of a VCC program likely averts unnecessary IVCs. Law enforcement interviews affirmed the positive impact of VCC due to its ease of use and the benefits it provides to the individuals in need, the first responders involved, law enforcement resources, and the community.
心理健康危机可能给个人、家庭和社区带来挑战。这个多方面的问题通常涉及执法和医疗保健系统的不同专业人员，这可能导致护理工作孤立且效果不佳。虚拟危机护理（VCC）项目旨在为农村执法人员提供与行为健康专业人员接触的机会，并通过远程医疗技术促进协作护理。
本研究旨在评估农村地区远程医疗中心为执法部门实施和使用的VCC项目。
本研究采用混合方法。定量数据来自远程医疗中心的电子记录系统。定性数据来自对采用VCC项目的18个县的执法人员进行的深入访谈。
在181次VCC接触中，远程医疗中心建议的处置方式与实际处置方式在原地留观（分别为n = 141，77.9%和n = 137，75.7%）、自愿入院（分别为n = 9，5.0%和n = 10，5.5%）以及非自愿住院（IVC；分别为n = 27，14.9%和n = 19，10.5%）方面相似。确定了与VCC项目的实施、使用、益处和挑战相关的定性见解，全面展现了农村执法人员与行为健康专业人员之间的虚拟合作关系。
使用VCC项目可能避免不必要的非自愿住院。执法人员访谈证实了VCC的积极影响，因为其使用方便，且能为有需要的个人、急救人员、执法资源和社区带来益处。
