title: Lived experience of involuntary transport under mental health legislation.
abstract: Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA. Sixteen interviews were conducted; most (n = 14) interviews in northern NSW regions: six with people who had been transported (consumers), four with carers, and six with service providers (two police, one paramedic, and three mental health nurses). For consumers and carers, the police response was often perceived as too intense, particularly if the person was not violent. Carers were often conflicted by having to call for emergency intervention. Service providers were frustrated by a lack of a coordinated interagency response, resourcing issues, delays at emergency departments, and lack of adequate training. A central theme across all groups was the importance of communication styles. As one participant (consumer) said: 'Everybody needs a lesson in kindness'. All groups agreed that high-risk situations necessitate police involvement. However, invocation of the MHA during a high-risk situation is fraught with stress and difficulties, leaving little room for empathetic communications. Effective and diverse, evidence-based, early intervention strategies - both consensual and non-consensual - are necessary to reduce the requirement for police involvement in mental health transports.
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Bradbury
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Hutchinson
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Hurley
authors.affiliation: Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Stasa
mesh_terms: D000488:Allied Health Personnel; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D004636:Emergency Service, Hospital; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D009517:New South Wales; D016495:Police; D014187:Transportation of Patients / Q000331:legislation & jurisprudence
keywords: Mental Health Act; emergency intervention; involuntary transport; involuntary treatment; mental health crisis; mental health legislation