Persons with mental disorders and suicidality in crisis or high-risk situations involving police negotiation: a systematic review.

Police negotiators respond to crisis and high-risk situations including mental health crises, but little is known about the nature, frequency and characteristics of these events. This systematic review examined literature about mental disorder and suicidality prevalence in negotiation events from peer-reviewed articles published within the last 20 years. Of 1455 articles identified, 11 met study inclusion criteria. Most contributed only indirect evidence using data on fatal police encounters, case reviews and analysis of communication techniques. Reliable prevalence estimates were not found, though findings suggest suicidality was a precipitating factor in more than half of events and was present during most events. Mental disorder (primarily substance use, mood and psychotic disorders) was also identified as a significant factor prior to and during events. Few articles described frequency or characteristics of these critical events. Further research is needed to inform frontline responses, resourcing and support pathways for police providing this crucial service.

Mapping the prison mental health service workforce in Australia.

OBJECTIVE: The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia. METHODS: We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016. RESULTS: Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community. CONCLUSION: Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks.

Interviewing persons with mental illness charged with murder or attempted murder: a retrospective review of police interviews.

Individuals with a mental illness may be particularly vulnerable during police interviews. Assessing fitness for police interview is vital for ensuring procedural fairness. This article reports the findings of a retrospective review of 31 police interviews of mentally ill persons charged with murder (n = 18) or attempted murder (n = 13) who appeared before the Queensland Mental Health Court. Police interviews were conducted for all murder and 50% of attempted murder cases. Possible or overt mental illness symptoms were present in all interviews. Symptoms of mental illness were pervasive in 36.7% of interviews, intermittent in 43.3% of interviews and seldom in 20% of interviews. Support persons were present for 9.7% of interviews, and legal representation was not present for any interview. These findings highlight the need to enhance access to support persons during interviews. Intersectoral collaboration between mental health services, forensic medical officers, police, public guardians and the legal sector is needed.

A comparison of the reported use of involuntary treatment orders within Australian jurisdictions.

OBJECTIVE: This paper identifies publicly available data about the use of involuntary treatment orders within Australia and considers whether this reporting is sufficient given the gravity of the intervention. METHOD: A search of mental health tribunal, health department and justice department annual reports was conducted to determine the use of involuntary treatment orders in Australia. RESULTS: Reporting of involuntary treatment orders varied significantly across jurisdictions; for example, South Australia reported 11,570 distinct orders made during a 12-month period while the Australian Capital Territory reported 627 for the same period. CONCLUSION: The publicly available data for involuntary treatment orders in Australia is inadequate for jurisdictional comparisons. This concern should be addressed to enable transparent public reporting and facilitate benchmarking.