加强退伍军人事务警察心理健康反应:试点转向医疗保健以减少风险

Caroline Mok, Christopher M Weaver, J. Rosenthal, Trent Pettis, R. Wickham
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引用次数: 3

摘要

精神健康非犯罪化的顺序拦截模型(SIM)描述了法律体系中的五个阶段,在这些阶段,精神疾病患者可以从该体系中转移出来接受治疗。执法是第一阶段,也是最有可能转移注意力的阶段。由于危机降级可以构成暴力行为的初级预防,因此对SIM的一种新的解释是作为威胁管理和暴力风险缓解的模型。治疗药物滥用和精神疾病的卫生保健环境是优化这种预防的良好环境。美国退伍军人事务部(Department of veterans Affairs)是一个全国性的此类机构,它还拥有自己的内部联邦警察部队。这项研究考察了14小时国家“培训师”课程的试点实施情况,重点是心理健康诊断、压力源、降级技术和转诊选择。本研究的目的是评估实施的可行性问题,建议全面项目的任何变化,并提供初步的结果分析。培训师(n = 35)在(a)知识和(b)技能领域表现出显著的测试前和测试后的增加,但在(c)态度或(d)作为培训师的感知效能方面没有。警察(n = 140)在(a)知识、(b)态度和(c)识别转移资源的技能这三个评估领域都表现出显著的进步。结果支持课程和程序的改变以及全面实施的进展。该课程有可能系统地加强警察对暴力行为的管理,同时使精神疾病合法化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Augmenting Veterans Affairs Police Mental Health Response: Piloting Diversion to Health Care as Risk Reduction
The sequential intercept model (SIM) of mental health decriminalization describes five stages in the legal system at which people with mental illness can be diverted out of that system and into treatment. Law enforcement represents the first stage and that with the highest potential for diversion. A novel interpretation of the SIM is as a model of threat management and violence risk mitigation since crisis de-escalation can constitute primary prevention of violent behavior. Health care settings that treat substance abuse and mental illness represent excellent settings in which to optimize such prevention. The U.S. Department of Veteran Affairs is a nationwide system of such settings and also maintains its own internal federal police force. This study examined the pilot implementation of a 14-hr national “train-the-trainer” curriculum, focusing on mental health diagnoses, stressors, de-escalation techniques, and referral options. The goals of this study were to evaluate feasibility-of-implementation issues, recommend any changes for the full-scale project, and provide preliminary analysis of outcomes. Trainers (n = 35) exhibited significant pre- to posttest increases in the domains of (a) knowledge and (b) skill, but not in (c) attitudes or (d) perceived efficacy as a trainer. Police officers (n = 140) demonstrated significant gains in all three assessed domains of (a) knowledge, (b) attitudes, and (c) skill in identifying diversion resources. The results supported changes to the curriculum and procedure as well as progression to the full-scale implementation. The curriculum has the potential to systematically enhance officer management of violent behavior while simultaneously decriminalizing mental illness.
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