Recently, transport of patients with psychiatric problems has received attention in the media. The operations for psychiatry and habilitation feel that the reporting needs to be clarified to give a balanced picture.
For many years now, there has been a collaboration forum where psychiatry in Region Västernorrland and the police authorities meet approximately 3-4 times a year. Ambulance healthcare and primary care also have the opportunity to participate there.
– I feel that there has been a good dialogue with our partners based on the conditions provided by the law. We have been able to raise questions, deviations and various proposals for further development and improvement. I don’t recognize myself in the image that is now being highlighted in the media – or that it has been raised as a problem before, says regional director of the county health care area psychiatry and habilitation Kristina Mårtensson.
Full confidence in the police
The proportion of patients who come with the police to the psychiatric emergency department is about 10 percent of the total number of about 1,900 patients distributed among 5,000 contacts across the entire county. From Örnsköldsvik there are between 1 and 1.5 police transports per week.
– In some cases, it is the police themselves who have taken care of the person. Otherwise, it happens after primary care or hospital care has requested “police assistance” to transport a person for assessment and possible compulsory care. We have full confidence that the police themselves will decide what measures are necessary for safe transport, if there is a need for handcuffs, plastic cages or spit hoods, says Kristina Mårtensson.
Assessment and request for assistance
The doctor or healthcare professional who requests police assistance has made an assessment that there is a need for this. Healthcare has no possibility of using physical coercion to bring a patient to a healthcare facility, only the police can do that. There are also no methods to predict whether an individual will commit violence or suicide attempts during a transport, but an assessment of the risk is made.
– If the risk is high, it may be safer to request assistance from the police than to risk someone jumping out of the taxi during the journey or becoming violent during the transport. In retrospect, this may certainly turn out to be “unnecessary” for certain transports, but that is not something we can know in advance. It is also quite common for anxious and aggressive people to calm down when they are put in a police car, explains Kristina Mårtensson.
Risk patients are always transported to Sundsvall
Compulsory care for psychiatric reasons according to the law on compulsory psychiatric care, LPT takes place only in Sundsvall. That’s how it’s always been. Compulsory care has not been carried out either in Sollefteå or Örnsköldsvik in the psychiatric care wards that were there. Patients who are assessed as “risk patients” with a violent behavior or in need of compulsory care for any reason, have always been transported to the psychiatric emergency department in Sundsvall for assessment and enrollment in inpatient care.
– To “draw all psychiatric patients over one comb” is to simplify the picture in an incorrect way. The vast majority of people who are in need of emergency psychiatric care are not dangerous “risk individuals”, but completely ordinary people who feel bad mentally for many different reasons. The differences – and the needs – are very large within this patient group. This means that different ways of transporting psychiatric patients will be needed and that the police’s special powers will also be needed in the future for certain transports, says Kristina Mårtensson.
Children and young people in need of emergency round-the-clock psychiatric care
Since 2022, there is also a child psychiatric ward in Region Västernorrland, which is located in Sundsvall. Previously, there was no opportunity to care for minors in the county, but children and young people under the age of 18 had to be transported to other parts of the country when there was a need for inpatient care. It was considerably longer journeys than today.
– Even children and young people who need emergency round-the-clock psychiatric care are usually transported with a procured sick trip by taxi, police assistance is only requested when it has been assessed that there is a risk of not being able to carry out a safe transport for the patient or accompanying person, says Kristina Mårtensson.
Facts about transport to the psychiatric emergency department:
- The transports to the psychiatric emergency department in Sundsvall from the hospitals in Örnsköldsvik and Sollefteå, often take place by taxi journey ordered by the health care. Then the patient goes in a regular taxi with a “companion” for safety reasons.
- The taxi company is procured by the region specifically for this purpose and goes directly to the psychiatric ward and does not take other travelers with it, in comparison with other medical trips.
- The region lacks its own so-called assessment cars, as there are in some other regions, for patient groups who can ride seated in a regular car.
- A few patients come to the psychiatric emergency department by ambulance transport from other parts of the county, this applies above all from Örnsköldsvik.
