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[猬实项目:与执法部门合作帮助医疗系统的“逃亡者”]

[ÉCHINOPS Project: Collaborating with Law Enforcement to Help the Escapees of the Healthcare System].

作者信息

De Benedictis Luigi, Bouchard Amélie, Thériault Gabriel, McGuire William, Goulet Marie-Hélène, Larue Caroline

机构信息

Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada.

Université de Montréal, Québec, Canada.

出版信息

Sante Ment Que. 2024 Fall;49(2):247-270.

Abstract

Objectives In Canada, it is estimated that 5 to 31% of police interventions involve people with mental health disorders. The objective of this review of the scientific literature is to raise a myriad of issues in the approach to these patients in the community. We then illustrate this context with a Montreal initiative: The ÉCHINOPS Project (Hybrid Community Team for Innovative Interventions NPO-Psychiatry-SPVM). Method A bibliographic search was carried out in June 2022 on Pubmed, EMBASE, PsycINFO and CINAHL, using MeSH words Police, Law Enforcement, Crisis Intervention, Mental Health Services, Mental Disorders, Mentally Ill Persons, Intersectoral Collaboration, Interprofessional Relations, Interdisciplinary Communication, Patient Care Team and about 40 different key words, leading us to more than 1100 articles, regardless of the time and language of publication. Two members of the research team read the titles and abstracts to retain about 100 articles. Snowball research of bibliographies eventually lead to a sample of about 110 articles. We used the software Zotero version 6.0.37 to manage the sample. They had to be published either in French or English. We then organized our data into sections to summarize the issues: Interactions Between Patients and Police Officers and Procedural Justice; Use of Force and Morbidity; Transport to a Hospital Center; Judicialization; Consultation and Resolution of Situations on Stage; Access to Mental Healthcare and Hospitalizations; Experiences and Satisfaction of Citizens and Beneficiaries; Experiences and Satisfaction of Healthcare Providers; Economic Aspects. Results Over the last 40 years, the deinstitutionalization of psychiatric services has led to an increase in contacts between mental health patients and law enforcement. While demonstrating a cultural change regarding the role of police officers in the general population, initiatives around the world highlight a need for additional training on mental illness and growing interdisciplinarity between police services and the healthcare system. This need requires the development of partnerships and new models of collaboration in the community. Conclusion Made up of mental health nurses and community psychiatrists, the ÉCHINOPS Project team works in collaboration with police forces to play a consulting role and to implement and consolidate mixed practices for people with mental health issues. The team's operation is inspired by the models of mixed intervention teams known as "Co-response" or "Street Triage" which have been the subject of several projects in Canada and other Western countries. A mixed intervention team has taken off as part of a pilot project in Montreal's East-end since January 2022.

摘要

目标 在加拿大,据估计5%至31%的警察干预涉及患有精神疾病的人。对科学文献进行此次综述的目的是提出社区中针对这些患者的处理方法中的诸多问题。然后,我们用蒙特利尔的一项举措来说明这种情况:海胆项目(创新干预混合社区团队,非营利组织 - 精神病学 - 蒙特利尔市警察局)。方法 2022年6月,在PubMed、EMBASE、PsycINFO和CINAHL数据库中进行了文献检索,使用医学主题词“警察”“执法”“危机干预”“心理健康服务”“精神障碍”“精神疾病患者”“部门间合作”“专业间关系”“跨学科交流”“患者护理团队”以及约40个不同的关键词,检索出超过1100篇文章,无论其发表时间和语言。研究团队的两名成员阅读了标题和摘要,筛选出约100篇文章。通过文献的滚雪球式研究最终得到约110篇文章的样本。我们使用Zotero 6.0.37软件来管理样本。这些文章必须以法语或英语发表。然后,我们将数据整理成不同部分以总结问题:患者与警察之间的互动及程序正义;武力使用与发病率;送往医院中心;司法化;现场情况的咨询与解决;获得精神卫生保健与住院治疗;公民和受益人的体验与满意度;医疗服务提供者的体验与满意度;经济方面。结果 在过去40年里,精神科服务的去机构化导致精神卫生患者与执法部门之间的接触增加。世界各地的举措在表明公众对警察角色的文化转变的同时,也凸显了对精神疾病进行额外培训以及警察部门与医疗系统之间日益增长的跨学科性的需求。这种需求需要在社区中发展伙伴关系和新的合作模式。结论 海胆项目团队由精神科护士和社区精神科医生组成,与警察部队合作,发挥咨询作用,并为有精神健康问题的人实施和巩固混合实践。该团队的运作受到被称为“联合应对”或“街头分诊”的混合干预团队模式的启发,这些模式在加拿大和其他西方国家是多个项目的主题。自2022年1月起,一个混合干预团队已作为蒙特利尔东区一个试点项目的一部分启动。

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