Characteristics of Persons Referred by Police to the Psychiatric Emergency Room

McNiel, Dale E.; Hatcher, Chris; Zeiner, Harriet; Wolfe, Harriet L.; Myers, Richard S.

doi:10.1176/ps.42.4.425

Cited by 30 publications

(35 citation statements)

References 3 publications

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“…The results of the pilot study are consistent with the literature in that police officers tend to focus primarily on violence potential and issues of public safety (Broussard et al, 2010;Citrome & Volaka, 1999;Kneebone et al, 1995;Lee et al, 2008;Lyons et al, 1997;Marson et al, 1988;McNiel et al, 1991;Meadows et al, 1994;Mulder et al, 2005;Redondo & Currier, 2003;Reinish & Ciccone, 1995;Sales, 1991;Watson et al, 1993;Way et al, 1993). However, unlike previous research, which is based almost exclusively on hospital records of ED presentations and admissions, the current study used data obtained from police officers.…”

Section: Discussionsupporting

confidence: 82%

“…They are primarily concerned with potential for harm to self or others because their legislative authorities emphasize violence potential (see for example, S. 17, MHA, Ontario, 1990). A number of studies confirm that the most common characteristic associated with PSMD referred to hospital by police officers is violent or aggressive behavior toward self or others (Broussard, McGriff, Demir Neubert, D'Orio, & Compton, 2010;Citrome & Volaka, 1999;Kneebone, Rogers, & Hafner, 1995;Lee, Brunero, Fairbrother, & Cowan, 2008;McNiel, Hatcher, Zeiner, Wolfe, & Myers, 1991;Meadows, Calder, & Van Den Bos, 1994;Redondo & Currier, 2003;Reinish & Ciccone, 1995;Sales, 1991;Watson, Segal, & Newhill, 1993;Way et al, 1993).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…As to ED physicians, although many variables enter into their assessment, severity of symptoms and diagnoses such as schizophrenia, psychosis, and manic disorders appear to be major factors (Lyons et al, 1997;Marson, McGovern, & Pomp, 1988;McNiel et al, 1991;Mulder, Koopmans, & Lyons, 2005). Patients with violent tendencies represent a somewhat unique case.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

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The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

Hoffman

Hirdes

Brown

et al. 2016

International Journal of Law and Psychiatry

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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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Section: Discussionsupporting

confidence: 82%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

See 1 more Smart Citation

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

Hoffman

Hirdes

Brown

et al. 2016

International Journal of Law and Psychiatry

View full text Add to dashboard Cite

show abstract

“…Other dimensions from the SPI did not enter into the model. Although danger to others has been associated with hospitalisation in most of the studies 4,17,18 our results are similar to those in which it was not found to be associated 8,27 . Finally, although the model correctly predicted the 87% of discharge decisions it only explained 31% of hospitalization suggesting that other variables not studied may play a role.…”

Section: Dual Diagnosis In Emergency Room 153supporting

confidence: 86%

Dual diagnosis in the psychiatric emergency room in Spain

et al. 2006

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-Background and Objectives: Dual diagnosis is associated with increased emergency department service use. During recent years, increased emphasis has been given to monitor the decision to hospitalise the most sever patients. Many rating scales have developed based on patient-related factors. To assess the level of severity of dual diagnosis patients measured by the Severity Psychiatric Illness (SPI) Scale and to evaluate it as a tool for predicting discharge in emergency psychiatric practice.Methods: Data on 1,227 consecutive admissions visited in a psychiatric emergency room of a general teaching hospital during a period of six months were collected. A routine computerised protocol was completed which included socio-demographic, clinical and social factors and the SPI scale.Results: 206 admissions (17%) had dual diagnosis disorder, 106 (9%) had substance abuse disorder (SUD), and 906 (74%) had non-substance abuse disorder (NSUD). Differences among groups were found in clinical characteristics, discharge decision, readmissions, previous psychiatric history, reason for referral, DSM-IV diagnosis and illicit drug use. Dual diagnosed patients had the highest scores of severity. Logistic regression analyses revealed the independent contribution of different SPI'items. The model showed a good fit and indicated excellent calibration in the sample studied, predicting 87.6% of discharge decisions.

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“…The police are very often the first to be called to deal with persons with mental health emergencies (1)(2)(3)(4).…”

mentioning

confidence: 99%

The Police and Mental Health

Lamb¹,

Weinberger²,

DeCuir³

2002

366

245

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With deinstitutionalization and the influx into the community of persons with severe mental illness, the police have become frontline professionals who manage these persons when they are in crisis. This article examines and comments on the issues raised by this phenomenon as it affects both the law enforcement and mental health systems. Two common-law principles provide the rationale for the police to take responsibility for persons with mental illness: their power and authority to protect the safety and welfare of the community, and their parens patriae obligations to protect individuals with disabilities. The police often fulfill the role of gatekeeper in deciding whether a person with mental illness who has come to their attention should enter the mental health system or the criminal justice system. Criminalization may result if this role is not performed appropriately. The authors describe a variety of mobile crisis teams composed of police, mental health professionals, or both. The need for police officers to have training in recognizing mental illness and knowing how to access mental health resources is emphasized. Collaboration between the law enforcement and mental health systems is crucial, and the very different areas of expertise of each should be recognized and should not be confused.

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Characteristics of Persons Referred by Police to the Psychiatric Emergency Room

Cited by 30 publications

References 3 publications

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

Dual diagnosis in the psychiatric emergency room in Spain

The Police and Mental Health

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