The use of warrants within the psychiatric crisis setting; a thematic analysis informed by the constant comparative method used in grounded theory

Abstract

On the 1st of April 2000, the Mental Health (Compulsory Assessment and Treatment) Amendment 1999 was enacted. The Amendment sought to address concerns about the Mental Health Act, from all sections of the community. For the most part the amendment only made changes to specific words, thereby giving clarity to previously identified grey areas. Some sections of the Act were repealed and new paragraphs were added. These changed the way Duly Authorised Officers Duly Authorised Officer: "Means a person who is designated and authorised by a Board...to perform the function and exercise the power...under this Act" (Mental Health Act, 1992, p.4). under the Act worked. Of relevance to this thesis was the addition of paragraph Section 41(7) to the Act, which states The member of police must not exercise the power in Subsection (2) [Entering Premises and Detaining/Transporting My Words] without a warrant, if it would be reasonably practicable to obtain a warrant (Mental Health (Compulsory Assessment and Treatment) Amendment, 1999, p.21). Prior to this addition, all that was required when asking for police assistance was for the Duly Authorised Officer to verbally request police assistance, and to authorise the attending police officer, under Section 41 of the Mental Health Act, to carry out the required function. The Amendment changed practice in that now Duly Authorised Officers had to have the appropriate warrants for apprehending and/or entering a person's premises before they could have the assistance of the police. This change in process impacted on the practice of the Duly Authorised Officers and is the focus of this thesis. Duly Authorised Officers located in the Canterbury, Ashburton, and Aoraki regions were asked to identify what impact, effect and implications this amendment had had on their practice since its enactment. A postal questionnaire gathered this information, which was then analysed for thematic content. The core category within this research entitled "No Impact/Change" relates to the majority of participants, but not all. This research discovered that apart from the initial confusion around the warrant process and the resulting protraction in crisis intervention, which led to increased stress and anxiety for Duly Authorised Officers, there was no ongoing impact or effect on their practice. The data identified that Duly Authorised Officers of the Canterbury and Ashburton regions are not getting involved in the process of obtaining warrants because of a general belief that warrants are neither necessary nor practicable to apply to a psychiatric emergency. Therefore, Section 41(7) does not impact on or change their practice. There is a paradox to this trend however, four participants from the Aoraki region who come under the same clinical directorship/Director of Area Mental Health Services as the Canterbury and Ashburton regions, were generally more positive about the obtaining of warrants compared to other participants. Within this region, warrants are always sought until such time that information at hand suggests that it is not practicable to obtain a warrant. Not all of these staff, like their colleagues, believes that warrants should be necessary. All agree however, that the process of obtaining warrants has much improved over time. The paradox here is we have two groups. Both indicate for the most part no change to or impact on their practice. In one group, this is because warrants are not sought due to lack of process/knowledge. For the other group, because there is an established process and all relevant people involved in the process understand their respective responsibilities, they too report no change or impact on their practice. The question the core category invoked was; why has Section 41(7) of the Act not influenced the participants practice in some way? This thesis examines the factors identified by these professionals, its implications for practice and offers some recommendations for the future.