25 October 2022

A police officer, a paramedic and a mental health clinician get out of a van: what PACER does next

| Lottie Twyford
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PACER representatives Julia Heffernan, Megan Davis and Anna Swain

CHS Mental Health, Emergency, Ambulance & Police Collaboration (MHEAPC) Clinical Lead Representative Julia Heffernan, with ACT Ambulance Service Lead Representative Megan Davis and Police Lead Representative Sergeant Anna Swain in front of the PACER vehicle. Photo: Lottie Twyford.

Until recently, there was only one option if you or a loved one was experiencing mental distress.

You’d call triple zero, the police would turn up with sirens blaring and you’d be taken to hospital for treatment.

That was the case even though emergency departments can be unfriendly, busy and overwhelming places for a person experiencing mental distress.

Things are changing, though, thanks to a collaboration between police officers, ambulance officers and clinicians.

The Police, Ambulance and Clinician Early Response (PACER) began life as a “proof of concept” in 2019.

Simply put, it’s a team of three who travel together in an unmarked vehicle – helping to remove any stigma associated with having a marked police vehicle called to a person’s house.

The police officer is there to secure the scene and ensure the physical safety of the person experiencing a mental health emergency, other onlookers and the other two team members.

The paramedic does a physical health check and addresses any medical needs.

And then, importantly, the mental health clinician can conduct a comprehensive mental health assessment of the patient.

The clinician can then recommend personalised care, provide the person with support and ultimately keep them out of hospital.

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PACER isn’t yet big enough to respond to every mental health call-out, although it has grown from its humble single-crew origins.

ACT Ambulance Service Lead Representative Megan Davis explained there’s one team covering the morning shift and one covering the afternoon/evening.

“We essentially provide PACER services from 8 am until midnight to support the emergency response to anyone having a mental health crisis in the community,” she said.

Ms Davis said PACER crews respond to a wide range of scenarios depending on what’s happened to trigger someone.

Sometimes, the team is called out to someone’s house. Sometimes, it’s a public setting where another member of the public has called triple zero because they are concerned about another person.

“We often find people are calling triple-zero because they don’t know where else to go,” she explained.

“Sometimes their crisis has got to the point where it is potentially life-threatening.”

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But for those they do get to, they are making a massive difference – 80 per cent of people PACER respond to aren’t admitted to hospital.

Instead, they receive support and care in their own homes or community.

And for those who do go to hospital, 80 per cent go on to be admitted – which means they need to be there.

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It’s not just about PACER, though.

A broader mental health revolution is underway across the Territory’s emergency services and frontline workers.

For example, since 2011, more than 2000 general duties police officers in the ACT have been put through the Enhanced Mental Health Training course, which is run by Mental Health, Emergency, Ambulance & Police Collaboration (MHEAPC).

All police recruits now undertake this course.

MHEAPC Clinical Lead Representative Julia Heffernan puts it simply: “We noted there is an interface across the three agencies for people with mental health problems.

“Our agencies need to be working together to support people as best we can. We need processes in place, and we need oversight of our systems.

“By inserting a mental health professional into emergency services, we can make clinically informed decisions … and bring in supports from our crisis teams, our community mental health teams, by making referrals or working with GPs.”

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PACER crews are deployed following a person contacting either triple-zero or the Access Mental Health Phone Line.

ACT Policing Lead Representative Sergeant Anna Swain said emergency services have always sat in the mental health response space because people ring triple-zero in an emergency.

“But we aren’t the most qualified; we aren’t medical professionals,” she said.

“These days, police officers do have better mental health literacy and know the pathways to follow because we do all of this cross-directorate training.”

The Access Mental Health line is available 24/7 for people with concerns about their own or someone else’s mental health on 1800 629 354.

In an emergency, dial triple zero.

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This is great news!!!! Recognising that people who are behaving strangely are distressed and frightened in many situations is a good start. Support and ensuring the person feels safe is essential to calm things down. Given that this small elite team is not always available, hopefully the newly trained police officers recognise mental distress, de-escalate situations by working with the person who is distressed, rather than automatically treating them as a criminal.

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