<p>Please click <a href="~/link.aspx?_id=2016A564795144FE88DE4E8BFD78E120&_z=z">here</a> to read a letter to the editor about this article. </p> <p> </p> <p>Stalking involves recurrent and persistent unwanted communication or contact that generates fear for safety in the victims. This pilot study evaluated the nature and prevalence of stalking among New Zealand nurses and physicians working in mental health services. An anonymous questionnaire asking respondents to describe their experiences with 12 stalking behaviors was distributed to 895 clinicians. Results indicated that regardless of discipline, women were more likely than men to have experienced one or more stalking behaviors, including receiving unwanted telephone calls, letters, and approaches; receiving personal threats; and being followed, spied on, or subject to surveillance. Women also reported higher levels of fearfulness as a consequence of stalking behaviors. Nearly half of the stalkers were clients; the remaining were former partners, colleagues, or acquaintances. In client-related cases, the majority of respondents told their colleagues and supervisors first, and the majority found them to be the most helpful resource. The results of this pilot study indicate a need for further research focused on the stalking of mental health clinicians in New Zealand and for development of workplace policies for adequate response to the stalking of mental health clinicians.</p> <h4>ABOUT THE AUTHORS</h4> <p>Dr. Hughes is Adjunct Professor, University of Technology, Sydney, and World Health Organization PIMHNet Facilitator, Porirua, Ms. Thom is Assistant Research Fellow, Centre for Mental Health Services Research, University of Auckland, Auckland, and Dr. Dixon is Associate Professor, School of Nursing, and Director, Centre for Child and Family Policy Research, University of Auckland, Auckland, New Zealand.</p> <p>The authors acknowledge Mr. Patrick Firkin and Dr. Deborah Widdowson for their involvement in the study. </p> <p>The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.</p> <p>Address correspondence to Frances A. Hughes, RN, DNurs, ONZM, Adjunct Professor, University of Technology, Sydney, and World Health Organization PIMHNet Facilitator, PO Box 58026, Whitby 5245, Porirua, New Zealand; e-mail: <a href="mailto:frances.hughes@clear.net.nz">frances.hughes@clear.net.nz</a>.</p>
The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 District Health Boards and the Auckland Regional Forensic Psychiatry Services (n = 121). The response rate was 88.4% (n = 107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A descriptive statistical analysis was undertaken and open-ended questions were analysed using content analysis. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. There are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
New Zealand police report a high level of involvement with people in mental health crisis, something that has been reported in the international literature in recent decades. Involvement of police represents a coercive pathway to care and is likely to be associated with use of force. The aim of this study was to investigate the clinical, legal, and social characteristics of individuals subject to police response in the Waikato region of New Zealand. Data were also collected on characteristics of police response, including use of force, time of day, and disposition. Use of force, most commonly use of handcuffs, occurred in 78% of cases involving police. The study showed that Māori were overrepresented in police responses, but no more likely than Europeans to experience use of force. Almost half those subject to police response were not subsequently admitted to hospital, raising questions about the need for and nature of police response in these cases. Because mental health nurses are often part of police response, nurses need to take cognisance of their relationship with police and contribute to any initiatives that can reduce coercion in the pathway to care, and improve service users' experience in mental health crises.
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