Police referrals to a psychiatric hospital: experiences of nurses caring for police-referred admissions

Int J Ment Health Nurs. 2013 Aug;22(4):313-21. doi: 10.1111/j.1447-0349.2012.00881.x. Epub 2012 Sep 25.

Abstract

Police are a major source of referral to psychiatric hospitals in industrialized countries with mental health legislation. However, little attention has been paid to nurses' experience of caring for police-referred patients to psychiatric hospitals. This study utilized a Heideggerian phenomenological framework to explore the experiences of nine nurses caring for patients referred by the police, through semistructured interviews. Two major themes emerged from the hermeneutic analyses of interviews conducted with nurse participants: (i) 'expecting "the worst" '; and (ii) 'balancing therapeutic care and forced treatment'. Expecting 'the worst' related to the perceptions nurse participants had about patients referred by the police. This included two sub-themes: (i) 'we are here to care for whoever they bring in'; and (ii) 'but who deserves care?' The second theme balancing therapeutic care and forced treatment included the sub-themes: (i) 'taking control, taking care'; and (ii) 'managing power'. The study raises ethical and skill challenges for nursing including struggling with the notion of who deserves care, and balancing the imperatives of legislation with the need to work within a therapeutic framework.

MeSH terms

  • Adult
  • Aggression / psychology
  • Alcoholism / nursing
  • Alcoholism / psychology
  • Attitude of Health Personnel*
  • Commitment of Mentally Ill* / legislation & jurisprudence
  • Comorbidity
  • Crisis Intervention
  • Female
  • Hospitals, Psychiatric* / legislation & jurisprudence
  • Humans
  • Internal-External Control
  • Interview, Psychological
  • Male
  • Middle Aged
  • New South Wales
  • Nurse-Patient Relations*
  • Police*
  • Power, Psychological
  • Psychoses, Substance-Induced / nursing
  • Psychoses, Substance-Induced / psychology
  • Referral and Consultation*
  • Substance-Related Disorders / nursing
  • Substance-Related Disorders / psychology