Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood).
Psychiatr Serv. 2023 Nov 1;74(11):1163-1170. doi: 10.1176/appi.ps.20220363. Epub 2023 Apr 18.
The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred the development of crisis response models to improve or reduce police response to a mental health crisis. However, limited research has explored preferences for crisis response, and no research in the United States has examined the responses desired by mental health care clients or their family members. This study aimed to understand the experiences of people with serious mental illnesses interacting with police and to learn about their preferences for crisis response models. The authors interviewed 50 clients with serious mental illnesses and a history of arrest who were enrolled in a randomized controlled trial of a police-mental health linkage system, as well as 18 of their family members and friends. Data were coded with deductive and inductive approaches and were grouped into larger themes. Clients and family or friends described needing a calm environment and empathy during a crisis. They selected a nonpolice response as their first choice and response from a crisis intervention team as their last choice among four options, highlighting the importance of trained responders and past negative interactions with police. However, they also noted concerns about safety and the shortcomings of a nonpolice response. These findings build understanding about clients' and family members' preferences for crisis response and highlight concerns that are relevant for policy makers.
严重精神疾病患者在刑事司法系统中的过度代表性促使人们开发危机应对模式,以改善或减少警察对精神健康危机的反应。然而,有限的研究探讨了对危机应对的偏好,而且在美国,没有研究探讨精神卫生保健客户或其家庭成员所期望的反应。本研究旨在了解与警察互动的严重精神疾病患者的经历,并了解他们对危机应对模式的偏好。作者采访了 50 名患有严重精神疾病且有被捕记录的客户,他们参加了一项警察-心理健康联系系统的随机对照试验,以及 18 名他们的家人和朋友。数据采用演绎和归纳方法进行编码,并分为更大的主题。客户和家人或朋友在危机期间描述需要一个平静的环境和同理心。他们在四个选项中选择非警察反应作为首选,选择危机干预小组的反应作为最后选择,这突出了受过培训的应对者的重要性以及过去与警察的负面互动。然而,他们也注意到了安全问题和非警察反应的缺点。这些发现增进了对客户和家庭成员对危机应对偏好的理解,并强调了决策者相关的关注点。