Recently, there has been much criticism towards law enforcement officers performing wellness checks that should be done by healthcare professionals. Yes, it’s true they are not trained to deal with these types of situations. However, by the same token healthcare professionals are often not adequately equipped to perform this same service. This does not mean they do not have the skills necessary to perform an assessment. The problem arises when they encounter either a client who suddenly becomes combative or family member(s) who become physically aggressive. So, what are the current shortcomings when dealing with these types of situations?

There are several issues here. The first is that law enforcement officers have not been trained to properly assess or communicate with a person having a mental health crisis. The second, unlike healthcare workers and healthcare security (more about them later) law enforcement officers have a greater latitude in dealing with persons who become aggressive or violent. In contrast, healthcare workers consider these clients to be vulnerable and not accountable for their actions The manner in which they are required to handle such persons becomes more restrictive and options are often limited due to mental health policies and guidelines. (This is also a problem in hospitals with assaults against nurses going unreported.)

In Canada, many healthcare workers, such as paramedics, have less protection under the law than do police officers, or police animals. Again, this increased liability creates more restrictions.

Earlier in my career I spent many years training healthcare security to safely handle patients that were off their medications, high on drugs, or any number of other issues that required physical intervention. The key to the success of my instruction related to being able  to ‘read’ the patient’s probable response and anticipate atypical patient reactions; and first and foremost teaching only those techniques that maximize the security officer’s mechanical advantage while minimizing the likelihood of residual damage in the patient. Unfortunately, law enforcement officers and most healthcare security officers do not have this specialized training or employ these techniques. Instead, they use generic training that is, for the most part, not suitable for dealing with persons having a mental health crisis.

Healthcare providers may have better training in performing the evaluation part of wellness checks. However, they do not have training to realistically handle physical intervention situations that may suddenly arise during a home visit.

So how can we help improve this situation? One approach that is currently being used is to have a law enforcement officer accompany the healthcare provider doing the wellness check. This is primarily done in cases where the client may be prone to violence. One shortcoming here is the officers still do not have the proper physical intervention skills. Therefore, the law enforcement, or Peace officer still requires proper training. Another shortcoming occurs when the healthcare provider attends a client alone, who suddenly becomes aggressive or violent. Here, proper training for the worker becomes paramount, given the absence of support.

The interdisciplinary approach (i.e., healthcare professional + law enforcement or Peace officer) seems to be a good start. However, a different and more appropriate way of training is still needed to protect the safety of both workers and clients to improve outcomes.

 

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