Co‐responding police–mental health programmes: Service user experiences and outcomes in a large urban centre

Abstract

As police officers are often the first responders to mental health crises, a number of approaches have emerged to support skilled police crisis responses. One such approach is the police-mental health co-responding team model, whereby mental health nurses and police officers jointly respond to mental health crises in the community. In the present mixed-method study, we evaluated outcomes of co-responding team interactions at a large Canadian urban centre by analysing administrative data for 2743 such interactions, and where comparison data were available, compared them to 16 226 police-only team responses. To understand service user experiences, we recruited 15 service users for in-depth qualitative interviews, and completed inductive thematic analysis. Co-responding team interactions had low rates of injury and arrest, and compared to police-only teams, co-responding teams had higher overall rates of escorts to hospital, but lower rates of involuntary escorts. Co-responding teams also spent less time on hospital handovers than police-only teams. Service users valued responders with mental health knowledge and verbal de-escalation skills, as well as a compassionate, empowering, and non-criminalizing approach. Current findings suggest that co-responding teams could be a useful component of existing crisis-response systems.

Review article: Clinical characteristics and outcomes of patient presentations to the emergency department via police: A scoping review

“…Critically, many aspects of clinical response may be required for patients BIBP, which includes assessment and management of substance misuse, injury, mental health problems and psychosocial stressors in addition to behaviour management. Difficulties for police in managing people with mental health and substance use problems in the community have led some police jurisdictions to adopt a co‐response (police and mental health) strategy . While such programmes have strong linkages with community services and reduce pressure on the justice system, there is limited evidence on other impacts .…”

“…While such programmes have strong linkages with community services and reduce pressure on the justice system, there is limited evidence on other impacts . A recent mixed‐methods study undertaken in Canada evaluated a police mental health co‐response team . The co‐response team had low rates of injury and arrest and when compared to a police only team response, had higher overall rates of voluntary escorts to hospital and lower rates of involuntary escorts.…”

“…Police in co‐response teams also spent less time on hospital handovers. Interviews with 15 service users indicated an appreciation of specialised mental health response, use of de‐escalation skills, compassion, empowerment and non‐criminalising approach . A similar model, termed Police Ambulance Crisis Emergency Response, exists in Australia .…”

Characteristics and outcomes of patient presentations made by police to an Australian emergency department

“…The healthcare needs of people who require police and or clinician engagement in the community tend to be for mental health related problems, drug, or alcohol related problems, with police required to respond because of a potential threat to the safety of the person or members of the community . While some of these people can have certain problems managed in the community with appropriate resources, others require transport to the ED for assessment .…”

Decriminalizing mental illness: specialized policing responses

“…This strategy was first employed by the Los Angeles County Sheriff's Department in 1992, known as Mental Evaluation Team, and in 1993 by the Los Angeles Police Department (LAPD), when it began deploying the Systemwide Mental Assessment Response Teams (SMART). 17 CRT provides emergency assessment and referral for individuals with mental illness who come to the attention of law enforcement through phone calls from community members or in-field law enforcement requests for emergency assistance. The mental health clinician has access to the information from the community's mental health system and the law enforcement officer can access past contacts with law enforcement and the local jail.…”