Work with law enforcement to reduce unwanted results

How can PMHNP consultations with law enforcement agencies reduce involuntary transfers and other unwanted outcomes?


About 25 percent of people with mental disorders in the United States have been arrested at some point in their lives, said Andrew Currivan, PMHNP-BC; Sondra Leiggi Brandon, MPH, PMHNP-BC; and Christine Loui, PMHNP-BC at the American Psychiatric Nurses Association (APNA) 36th Annual Conference. Currivan and colleagues discussed ways psychiatric doctors can collaborate with law enforcement during emergency psychiatric assessments in their presentation, “A PMHNP-led hospital team supporting law enforcement to reduce involuntary transfers to emergency departments “.

As few officers receive specialized crisis response training, the trio explained that PMHNPs can serve as expert advice and thus reduce law enforcement incident and emergency department overcrowding.

“The emergency health worker advises law enforcement with a person in crisis. We call them a personal crisis because they may have a mental health crisis, but the officer doesn’t know it and neither do we, until we have the story. Many times we are able to provide education in real time. We can provide patronage. We also try to distract people who do not need psychiatric treatment from being arrested, ”Brandon said.

In Hawaii, where the three work, a law states that a police officer must call a mental health worker to make an involuntary transfer to the emergency room, acknowledging that they are unable to determine if an individual needs psychiatric care and must obtain a professional opinion. This process is called MH-1. Between January 2020, when the program began in August 2022, more than 6,700 calls brought MH-1 in an attempt to “decriminalize mental health.”

Crisis Response Team (CIT) training may be able to help police officers learn how to best manage these situations, the trio said. CIT training is a one-week intensive training program that police officers go through and that does simulation work to teach them how to assess if someone has a mental illness, rather than assuming that every angry individual on the street has an illness. mental. Part of that training, the trio explained, is helping them build a relationship with an individual, rather than just getting facts. “It teaches them how to go through an algorithm in their head to be able to get closer to people and how to talk to people with mental illness,” Brandon said.

In addition, the trio strongly supported the use of community resources, so as not to overload the emergency departments. “We want them to have access to resources they don’t have on their way to the ER.”

One such resource is an awareness project for the homeless: a safe place with police and social workers. This allows people to access community resources informed about the trauma, the group explained, rather than medical services. “Our goal is to improve continuity of care. We want to make sure that not only can we help these people in crisis, but that we can draw resources from them. We also want to do it with the least traumatic means available, “Currivan said.” The last thing we want to do is host or mistreat them, throw them in handcuffs, throw them in the back of a police car and then tie them to a stretcher in the emergency room. “.

To further understand the experience of their law enforcement colleagues, 2 of the speakers said they volunteered for the community police officers program. Understanding the “other side” has helped them be better partners in their ongoing relationship.

The presentation by Currivan et al was among the many discussions at the APNA Annual Conference on Improving Mental Health Care for Patients.

The meeting was held October 20-22, 2022 in Long Beach, California.

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