Police and clinician diversion of people in mental health crisis from the Emergency Department: A trend analysis and cross comparison study

Journal article


McKenna, Brian, Furness, Trentham, Brown, Steve, Tacey, Mark, Hiam, Andrew and Wise, Morgan. (2015). Police and clinician diversion of people in mental health crisis from the Emergency Department: A trend analysis and cross comparison study. BMC Emergency Medicine. 15(1), pp. 1 - 6. https://doi.org/10.1186/s12873-015-0040-7
AuthorsMcKenna, Brian, Furness, Trentham, Brown, Steve, Tacey, Mark, Hiam, Andrew and Wise, Morgan
Abstract

Background: The Northern Police and Clinician Emergency Response (NPACER), a combined police and clinician second response team, was created to divert people in mental health crisis away from the hospital emergency department (ED) to care in the community or direct admission to acute inpatient services. The aim of this study was to evaluate the NPACER by comparing trends in service utilisation prior to and following its inception. Methods: A retrospective comparison of electronic records was undertaken with interrupted time series analysis to assess the impact of NPACER on ED presentations over 27-months (N = 1776). Chi-squared tests were used to analyze service utilization; (1) in the six-months before and after the implementation of NPACER and (2) within the post NPACER period between times of the day it was operational. Results: NPACER reduced the number of mental health crisis presentations to the ED. When the NPACER team was operational, 16 % of people in crisis went to ED compared with 100 % for all other times of the day, over a six-month period. The NPACER team enabled direct access to the inpatient unit for 51 people assessed at a police station and in the community compared with no direct access when NPACER was not operational. Conclusions: NPACER enabled reductions in presentations to the ED by diverting people to more appropriate and less restrictive environments. The model also facilitated direct admission to acute inpatient mental health services when people in crisis were assessed in the community or transported to a police station for assessment.

Year2015
JournalBMC Emergency Medicine
Journal citation15 (1), pp. 1 - 6
ISSN1471-227X
Digital Object Identifier (DOI)https://doi.org/10.1186/s12873-015-0040-7
Open accessOpen access
Page range1 - 6
Research GroupSchool of Nursing, Midwifery and Paramedicine
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McKenna, Brian. (2011). Mental health and addiction services in the criminal justice system: Where do we sit? International Journal of Mental Health Nursing. 20(2), pp. 75 - 76. https://doi.org/10.1111/j.1447-0349.2010.00738.x
In search of a national approach to professional supervision for mental health and addiction nurses : The New Zealand experience
McKenna, Brian, Thom, Katey, Howard, Fiona and Williams, Val. (2010). In search of a national approach to professional supervision for mental health and addiction nurses : The New Zealand experience. Contemporary Nurse: Health care across the lifespan. 34(2), pp. 267 - 276. https://doi.org/10.5172/conu.2010.34.2.267
Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults
Furness, Trentham, Maschette, Wayne, Lorenzen, Christian, Naughton, Geraldine and Williams, Morgan. (2010). Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults. Journal of Alternative & Complementary Medicine. 16(7), pp. 795 - 797. https://doi.org/10.1089/acm.2009.0366
Duly authorized officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?: Feature article
McKenna, Brian, Thom, Katey, O'Brien, Anthony John, Crene, Sally and Simpson, A.. (2009). Duly authorized officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?: Feature article. International Journal of Mental Health Nursing. 18(4), pp. 231 - 238. https://doi.org/10.1111/j.1447-0349.2009.00619.x
Community treatment orders and competence to consent
Milne, Duncan, O'Brien, Anthony John and McKenna, Brian. (2009). Community treatment orders and competence to consent. Australasian Psychiatry. 17(4), pp. 273 - 278. https://doi.org/10.1080/10398560902721572
Compulsory community mental health treatment: Literature review
O'Brien, Anthony John, McKenna, Brian and Kydd, Robert R.. (2009). Compulsory community mental health treatment: Literature review. International Journal of Nursing Studies. 46(9), pp. 1245 - 1255. https://doi.org/10.1016/j.ijnurstu.2009.02.006
Judging nursing practice: Implications of habeas corpus rulings for mental health nurses in New Zealand
Thom, Katey, O'Brien, Anthony John and McKenna, Brian. (2008). Judging nursing practice: Implications of habeas corpus rulings for mental health nurses in New Zealand. Psychiatry, Psychology and Law. 15(1), pp. 131 - 139. https://doi.org/10.1080/13218710701879558
Return to nursing programmes: Justifications for a mental health specific course
McKenna, Brian, Thom, Katey and O'Brien, Anthony John. (2008). Return to nursing programmes: Justifications for a mental health specific course. International Journal of Nursing Education Scholarship. 5(1), pp. 1 - 16. https://doi.org/10.2202/1548-923X.1618
The unintended impact of the therapeutic intentions of the New Zealand Mental Health Review Tribunal? Therapeutic jurisprudence perspectives
Diesfeld, Kate and McKenna, Brian. (2007). The unintended impact of the therapeutic intentions of the New Zealand Mental Health Review Tribunal? Therapeutic jurisprudence perspectives. Journal of Law and Medicine. 14(4), pp. 566 - 574.
Concerns about the use of TASERs on people with mental illness in New Zealand
O'Brien, Anthony John and McKenna, Brian. (2007). Concerns about the use of TASERs on people with mental illness in New Zealand. Journal of Forensic Nursing. 3(2), pp. 89 - 92. https://doi.org/10.1097/01263942-200706000-00008
Outcome of patients rehabilitated through a New Zealand Forensic Psychiatry Service: A 7.5 year retrospective study
Simpson, Sandy, Simpson, A., Jones, Roland Morgan, Evans, Ceri G. and McKenna, Brian. (2006). Outcome of patients rehabilitated through a New Zealand Forensic Psychiatry Service: A 7.5 year retrospective study. Behavioral Sciences and the Law. 24(6), pp. 833 - 843. https://doi.org/10.1002/bsl.740
Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: A national study
Simpson, A., Skipworth, Jeremy J., McKenna, Brian, Moskowitz, Andrew K. and Barry-Walsh, Justin B.. (2006). Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: A national study. Australian and New Zealand Journal of Psychiatry. 40(9), pp. 804 - 809. https://doi.org/10.1111/j.1440-1614.2006.01887.x
The therapeutic intent of the New Zealand Mental Health Review Tribunal
Diesfeld, Kate and McKenna, Brian. (2006). The therapeutic intent of the New Zealand Mental Health Review Tribunal. Psychiatry, Psychology and Law. 13(1), pp. 100 - 109. https://doi.org/10.1375/pplt.13.1.100
Best practice management strategies for mental health nurses during the clinical application of civil commitment: an overview
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006). Best practice management strategies for mental health nurses during the clinical application of civil commitment: an overview. Contemporary Nurse. 21(1), pp. 62 - 70. https://doi.org/10.5172/conu.2006.21.1.62
Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992
McKenna, Brian, O'Brien, Anthony John, Dal Din, Toni and Thom, Kate. (2006). Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992. International Journal of Mental Health Nursing. 15(2), pp. 128 - 134. https://doi.org/10.1111/j.1447-0349.2006.00412.x
The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000
Moskowitz, Andrew K., Simpson, A., McKenna, Brian, Skipworth, Jeremy J. and Barry-Walsh, Justin B.. (2006). The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000. Journal of Forensic Psychiatry and Psychology. 17(3), pp. 417 - 430. https://doi.org/10.1080/14789940600761410
Outpatient commitment and coercion in New Zealand: A matched comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006). Outpatient commitment and coercion in New Zealand: A matched comparison study. International Journal of Law and Psychiatry. 29(2), pp. 145 - 158. https://doi.org/10.1016/j.ijlp.2004.07.004
Gambling and problem gambling among recently sentenced women in New Zealand prisons
Abbott, Max W. and McKenna, Brian. (2005). Gambling and problem gambling among recently sentenced women in New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 559 - 581. https://doi.org/10.1007/s10899-005-5563-5
Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons
Abbott, Max W., McKenna, Brian and Giles, Lynne C.. (2005). Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 537 - 558. https://doi.org/10.1007/s10899-005-5562-6
New nurses face endemic violence
McKenna, Brian, Poole, Suzette J., Smith, Naumai A. and Cloverdale, John H.. (2004). New nurses face endemic violence. Kai Tiaki: Nursing New Zealand. 10(5), pp. 12 - 14.
Homicide and mental illness in New Zealand, 1970-2000
Simpson, A., McKenna, Brian, Moskowitz, Andrew K., Skipworth, Jeremy J., Barry-Walsh, Justin B. and Simpson, Sandy. (2004). Homicide and mental illness in New Zealand, 1970-2000. British Journal of Psychiatry. 185(NOV), pp. 394 - 398. https://doi.org/10.1192/bjp.185.5.394
Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2003). Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study. International Journal of Law and Psychiatry. 26(4), pp. 355 - 372. https://doi.org/10.1016/S0160-2527(03)00046-3
Horizontal violence: Experiences of Registered Nurses in their first year of practice
McKenna, Brian, Smith, Naumai A., Poole, Suzette J. and Cloverdale, John H.. (2003). Horizontal violence: Experiences of Registered Nurses in their first year of practice. Journal of Advanced Nursing. 42(1), pp. 90 - 96. https://doi.org/10.1046/j.1365-2648.2003.02583.x
Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002). Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation. International Journal of Mental Health Nursing. 11(3), pp. 164 - 169.
Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002). Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice. Nursing Praxis in New Zealand. 18(2), pp. 15 - 23.
Risk assessment of violence to others: time for action
McKenna, Brian. (2002). Risk assessment of violence to others: time for action. Nursing Praxis in New Zealand. 18(1), pp. 36 - 43.
An analysis of procedural justice during psychiatric hospital admission
McKenna, Brian, Simpson, A., Cloverdale, John H. and Laidlaw, Tannis M.. (2001). An analysis of procedural justice during psychiatric hospital admission. International Journal of Law and Psychiatry. 24(6), pp. 573 - 581. https://doi.org/10.1016/S0160-2527(00)00069-8
Debating forensic mental health nursing
McKenna, Brian and Poole, Suzette J.. (2001). Debating forensic mental health nursing. Kai Tiaki: Nursing New Zealand. 7(6), pp. 18 - 20.
What is the role of procedural justice in civil commitment?
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2000). What is the role of procedural justice in civil commitment? Australian and New Zealand Journal of Psychiatry. 34(4), pp. 671 - 676. https://doi.org/10.1046/j.1440-1614.2000.00744.x
Implications for training of violent acts by patients against psychiatry registrars
Gale, Christopher K., Simpson, A., McKenna, Brian and Cloverdale, John H.. (2000). Implications for training of violent acts by patients against psychiatry registrars. Australasian Psychiatry. 8(4), pp. 345 - 348. https://doi.org/10.1046/j.1440-1665.2000.00289.x
Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience
McKenna, Brian, Simpson, A. and Laidlaw, Tannis M.. (1999). Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience. International Journal of Law and Psychiatry. 22(2), pp. 143 - 153. https://doi.org/10.1016/S0160-2527(98)00039-9
To tell or not to tell?
McKenna, Brian. (1997). To tell or not to tell? Kai Tiaki: Nursing New Zealand. 3(4), pp. 28 - 29.