RESUMEN
Suicide is a major public health concern. In Canada, suicide is the ninth leading cause of death in all ages, with a rate of 10.3 deaths per 100,000 people. In Nova Scotia, Canada, 137 suicides were reported in 2016 [1]. Suicide risk assessment (SRA) and management are clinical competencies required for patient care. Strategies used for SRA include the use of formal self-report measures [2], personalized clinical interview however vital information about suicide risk may be missed during that unstructured assessment [3] and structured tool to supplement the clinical interview.
Asunto(s)
Suicidio , Femenino , Humanos , Masculino , Nueva Escocia/epidemiología , Medición de RiesgoRESUMEN
OBJECTIVES: Police are often the front-line response to people experiencing mental health crises. This study examined the impact of an integrated mobile crisis team formed in partnership between mental health services, municipal police, and emergency health services. The service offered short-term crisis management, with mobile interventions being attended by a plainclothes police officer and a mental health professional. METHODS: We used a mixed-methods design encompassing: a controlled before-and-after quantitative comparison of the intervention area with a control area without access to such a service, for 1 year before and 2 years after program implementation; and qualitative assessments of the views of service recipients, families, police officers, and health staff at baseline and 2 years afterward. RESULTS: The integrated service resulted in increased use by people in crisis, families, and service partners (for example, from 464 to 1666 service recipients per year). Despite increased service use, time spent on-scene and call-to-door time were reduced. At year 2, the time spent on-scene by police (136 minutes) was significantly lower than in the control area (165 minutes) (Student t test = 3.4, df = 1649, P < 0.001). After adjusting for confounders, people seen by the integrated team (n = 295) showed greater engagement than control subjects as measured by outpatient contacts (b = 1.3, chi square = 92.7, df = 1, P < 0.001). The service data findings were supported by the qualitative results of focus groups and interviews. CONCLUSIONS: Partnerships between the police department and mental health system can improve collaboration, efficiency, and the treatment of people with mental illness.