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Olmstead B, Hoffman R, Brown GP, Hirdes JP. Using the interRAI brief mental health screener to identify persons with mental disorders having repeat contact with police. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2022; 83:101816. [PMID: 35751991 DOI: 10.1016/j.ijlp.2022.101816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
Repeat contacts between persons with serious mental disorder (PSMD) and police officers are costly to both police services and hospitals in terms of service utilization and can be viewed as a direct indicator of unmet needs and gaps in service provision. The intent of the current study was to examine the demographic and clinical characteristics of PSMD who had repeat contact with police officers in London, Ontario from 2016 to 2019 using data collected using the interRAI Brief Mental Health Screener (BMHS). Negative binomial regression was used on a sample of 4143 cases to develop a model predictive of repeat police contacts. The most parsimonious model predicting police contact based on items on the BMHS included age, command hallucinations, lack of insight, verbal abuse, known to possess weapons and family, friends and caregivers expressing concern over the possibility of self harm. Delusions were also independently significantly associated with repeat encounters. Unique to this study is the observation that possessing a weapon in the past 12 months was included in the predictive model. The results of the study add to the sparse research devoted to identifying the characteristics of PSMD who have repeat contact with police officers. Recommendations include integrating the findings into police training to ensure police officers flag those who have the potential for repeat encounters and refer them to appropriate community mental health service providers for proactive outreach services.
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Affiliation(s)
- Benjamin Olmstead
- Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada
| | - Ron Hoffman
- Faculty of Applied and Professional Studies, Chair, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada.
| | - Gregory P Brown
- Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
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Scott R, Meehan T. Inter-agency collaboration between mental health services and police in Queensland. Australas Psychiatry 2017; 25:399-402. [PMID: 28462589 DOI: 10.1177/1039856217706823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this study was to consider the collaboration between mental health services and police in Queensland. CONCLUSION Queensland has developed a number of initiatives for intervention and response to incidents involving police and persons with mental illness. Future research should focus on identifying interventions that promote effective resolution of incidents involving police.
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Affiliation(s)
- Russ Scott
- Forensic Psychiatrist, The Park - Centre for Mental Health, Research and Treatment, Wacol, Brisbane, QLD, Australia
| | - Tom Meehan
- Associate Professor, Department of Psychiatry, School of Medicine, University of Queensland, St Lucia, Brisbane, QLD, Australia
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Hoffman R, Hirdes J, Brown GP, Dubin JA, Barbaree H. The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 47:28-35. [PMID: 27044526 DOI: 10.1016/j.ijlp.2016.02.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Police agencies in Canada and elsewhere have received much criticism over how they respond to persons with serious mental disorders. The adequacy of training provided to police officers on mental health issues and in particular on recognizing indicators of serious mental disorders has been a major concern. This paper describes the process that led to the development of a new brief mental health screener (interRAI Brief Mental Health Screener, BMHS) designed to assist police officers to better identify persons with serious mental disorders. The interRAI BMHS was developed in collaboration with interRAI, an international, not-for-profit consortium of researchers. The government of Ontario had previously partnered with interRAI to develop and implement the Resident Assessment Instrument for Mental Health (RAI-MH), the assessment system mandated for use on all persons admitted into inpatient psychiatric care in the province. Core items on the interRAI BMHS were obtained through analysis (N=41,019) of RAI-MH data together with input from representatives from health care, police services, and patient groups. Two police services in southwestern Ontario completed forms (N=235) on persons thought to have a mental disorder. Patient records were later accessed to determine patient disposition. The use of summary and inferential statistics revealed that the variables significantly associated with being taken to hospital by police included performing a self-injurious act in the past 30days, and others being concerned over the person's risk for self-injury. Variables significantly associated with being admitted included abnormal thought process, delusions, and hallucinations. The results of the study indicate that the 14-variable algorithm used to construct the interRAI BMHS is a good predictor of who was most likely to be taken to hospital by police officers and who was most likely to be admitted. The instrument is an effective means of capturing and standardizing police officer observations enabling them to provide more and better quality information to emergency department (ED) staff. Teaching police officers to use the form constitutes enhanced training on major indicators of serious mental disorders. Further, given that items on the interRAI BMHS are written in the language of the health system, language acts as common currency between police officers and ED staff laying the foundation for a more collaborative approach between the systems.
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Affiliation(s)
- Ron Hoffman
- Ministry of Community Safety and Correctional Services, Ontario Police College, 10716 Hacienda Road, Aylmer, Ontario N5H 2T2, Canada; Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L, Canada.
| | - John Hirdes
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Gregory P Brown
- Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada
| | - Joel A Dubin
- Department of Statistics and Actuarial Science, School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Howard Barbaree
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R, Canada; Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada
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Maharaj R, Gillies D, Andrew S, O'Brien L. Characteristics of patients referred by police to a psychiatric hospital. J Psychiatr Ment Health Nurs 2011; 18:205-12. [PMID: 21395912 DOI: 10.1111/j.1365-2850.2010.01653.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To identify any differences between patients referred by police compared with patients referred from other sources, to a psychiatric hospital in Australia, a retrospective audit of 200 patient files was undertaken. The two most common reasons for the involuntary referral of patients by police were bizarre ideas (33%) and threats of suicide (28%). When 101 patients referred by police were compared with 99 patients from other sources, police referrals were three times more likely to be diagnosed with a mental and behavioural disorder because of psychoactive substance use, less likely to be diagnosed with a mood disorder, and less likely to be diagnosed as psychotic. Police referrals were more likely to have worse functional scores; exhibit aggressive behaviour; spend fewer days in hospital; more likely to be admitted to the psychiatric intensive care unit, and to be secluded. The most important predictor for a police referral was drug or alcohol problems. The study indicates that patients referred by the police were more likely to demonstrate particular characteristics compared with patients referred by other sources.
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Affiliation(s)
- R Maharaj
- Sydney West Area Health Service, Parramatta BC, NSW, Australia.
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Lee S, Brunero S, Fairbrother G, Cowan D. Profiling police presentations of mental health consumers to an emergency department. Int J Ment Health Nurs 2008; 17:311-6. [PMID: 18789040 DOI: 10.1111/j.1447-0349.2008.00553.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Public mental health systems have been called on to better meet the needs of consumers presenting to health services with the police, yet few studies have examined police presentations among mental health consumers in large public mental health systems. This study was designed to determine the frequency profile and characteristics of consumers of mental health services brought in by police to an emergency department (ED) in Sydney, Australia. Using data from the emergency department information system and obtaining the psychiatric assessment from the medical record, we have examined trends and characteristics in mental health presentations brought in by the police to a general ED between 2003 and 2005. The sample consisted of 542 consumers with a mental health problem brought in by the police to the ED of a 350-bed community hospital. The characteristics of this group were compared with those of all mental health related ED presentations for the same period using logistic regression. Results indicated that police presentations are likely to be young males who are unemployed, have past and present alcohol and other drugs use, present after hours, and are admitted to hospital as a result of their presentation. These consumers are likely to have a presenting problem of a psychotic disorder, less likely to have a presenting problem of depression and/or anxiety, and given a triage code of three or higher. The study results highlight the importance of the availability of 24-hour access to mental health care to ensure a quick care delivery response. Police presentations to EDs with mental health issues are an indicator of significant impact on health services, especially with the current overcrowding of EDs and the associated long waiting times. Systems need to be developed that facilitate collaboration between EDs, hospital security, police services, mental health, and ambulance services.
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Affiliation(s)
- Soung Lee
- Enhanced Hospital Drug Health Consultation Liaison Services, Liverpool Hospital, Sydney, New South Wales, Australia.
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Fry AJ, O'Riordan DP, Geanellos R. Social control agents or front-line carers for people with mental health problems: police and mental health services in Sydney, Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2002; 10:277-286. [PMID: 12193172 DOI: 10.1046/j.1365-2524.2002.00371.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The relationship between mental health services and police and people who have mental health problems, are suicidal or are drug- and/or alcohol-affected is examined in this paper. A survey of 131 police officers in Sydney, Australia, revealed that more than 10% of police time is spent dealing with people with mental health problems. Nevertheless, police felt unsupported in this role, unprepared for it and torn between the competing demands experienced in their work. A lack of confidence in dealing with suicidal people and a belief that work with mentally disturbed people does not constitute valid police work are also reported. Managing people with mental disturbance is a major concern for police. Specifically, there are difficulties relating to: inadequate training and education; deficiencies in services/resources; time and resource over-utilization; communication, liaison and feedback problems, and frustration related to accessing mental health facilities/services. It is argued that police work involving mentally disturbed people is a valid and necessary role that complements law enforcement. In order to facilitate this aspect of police work, recommendations are made regarding education and collaborative working relationships between police and mental health professionals, which, in turn, could improve the care of mentally disturbed people in the community.
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Affiliation(s)
- A J Fry
- University of Western Sydney, School of Nursing, Family and Community Health, Penrith South DC, NSW, Australia.
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Abstract
Questionnaires were sent to all operational officers in a regional police service regarding their level of knowledge about and attitudes towards, mental illness. It was widely accepted by police officers that mental illness occurred commonly, can be effectively treated in the community and that the main risk of harm is to patients themselves. There was a good knowledge of relevant legislation, but most officers felt they did not have sufficient training in mental illness, and were keen for more. Improved liaison between sector psychiatrists and local police may be of value in the earlier identification and treatment of the mentally ill.
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Affiliation(s)
- S J Carey
- Department of Psychiatry, Crichton Royal Hospital, Dumfries.
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